CMS Formulary

Displaying 142901-142910 of 1611142 results.
ID: 142901
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205922
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142902
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205924
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142903
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142904
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 212219
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142905
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213475
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142906
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142907
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142908
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142909
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142910
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0