CMS Formulary

Displaying 142971-142980 of 1611142 results.
ID: 142971
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142972
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142973
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142974
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142975
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142976
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142977
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142978
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142979
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142980
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0