CMS Formulary

Displaying 143391-143400 of 1611142 results.
ID: 143391
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143392
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143393
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143394
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143395
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143396
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143397
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143398
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143399
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143400
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0