CMS Formulary

Displaying 142991-143000 of 1611142 results.
ID: 142991
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142992
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142993
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142994
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142995
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142996
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142997
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142998
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142999
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143000
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0