CMS Formulary

Displaying 143301-143310 of 1611142 results.
ID: 143301
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143302
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 204416
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143303
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143304
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 730781
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143305
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143306
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143307
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807552
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143308
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861379
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143309
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861383
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143310
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1743549
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0