CMS Formulary

Displaying 143251-143260 of 1611142 results.
ID: 143251
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143252
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143253
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143254
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143255
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143256
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143257
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143258
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143259
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040025
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143260
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0