CMS Formulary

Displaying 141-150 of 1611142 results.
ID: 141
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0