CMS Formulary

Displaying 143221-143230 of 1611142 results.
ID: 143221
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143222
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143223
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143224
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143225
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143226
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143227
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143228
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143229
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143230
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0