CMS Formulary

Displaying 143641-143650 of 1611142 results.
ID: 143641
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143642
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143643
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143644
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143645
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143646
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049891
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143647
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2048025
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143648
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143649
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1110806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143650
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0