CMS Formulary

Displaying 142051-142060 of 1611142 results.
ID: 142051
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797883
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 142052
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142053
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142054
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 602427
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142055
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 141859
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142056
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085736
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142057
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142058
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142059
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244634
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142060
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0