CMS Formulary

Displaying 143101-143110 of 1611142 results.
ID: 143101
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143102
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143103
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2260709
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143104
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143105
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143106
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 212039
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143107
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 212232
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143108
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 212373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143109
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143110
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0