CMS Formulary

Displaying 143721-143730 of 1611142 results.
ID: 143721
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143722
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835572
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143723
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143724
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143725
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143726
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143727
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143728
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143729
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143730
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0