CMS Formulary

Displaying 142791-142800 of 1611142 results.
ID: 142791
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142792
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142793
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142794
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142795
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142796
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142797
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142798
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142799
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142800
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0