CMS Formulary

Displaying 143931-143940 of 1611142 results.
ID: 143931
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143932
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830877
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143933
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830879
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143934
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830882
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143935
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143936
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 245723
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143937
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143938
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143939
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143940
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0