CMS Formulary

Displaying 142981-142990 of 1611142 results.
ID: 142981
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142982
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142983
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142984
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142985
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142986
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142987
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142988
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142989
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142990
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0