CMS Formulary

Displaying 142061-142070 of 1611142 results.
ID: 142061
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142062
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142063
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142064
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142065
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142066
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142067
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142068
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 142069
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142070
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0