CMS Formulary

Displaying 142011-142020 of 1611142 results.
ID: 142011
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 252479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142012
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 248642
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142013
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142014
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142015
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142016
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142017
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142018
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142019
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142020
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0