CMS Formulary

Displaying 143961-143970 of 1611142 results.
ID: 143961
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664463
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143962
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664440
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143963
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143964
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143965
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251190
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143966
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143967
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143968
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143969
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143970
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0