CMS Formulary

Displaying 143041-143050 of 1611142 results.
ID: 143041
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143042
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143043
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143044
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143045
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143046
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143047
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 607295
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143048
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143049
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143050
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0