CMS Formulary

Displaying 145201-145210 of 1611142 results.
ID: 145201
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145202
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145203
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145204
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145205
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 404062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145206
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 643488
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145207
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145208
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145209
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145210
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0