CMS Formulary

Displaying 143771-143780 of 1611142 results.
ID: 143771
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143772
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143773
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143774
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143775
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143776
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143777
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143778
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143779
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1874537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143780
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0