CMS Formulary

Displaying 142081-142090 of 1611142 results.
ID: 142081
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597126
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142082
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142083
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142084
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 142085
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142086
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142087
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191307
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142088
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142089
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142090
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0