CMS Formulary

Displaying 143091-143100 of 1611142 results.
ID: 143091
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143092
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143093
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143094
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143095
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143096
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 244967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143097
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143098
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143099
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143100
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0