CMS Formulary

Displaying 142091-142100 of 1611142 results.
ID: 142091
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142092
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142093
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 388517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142094
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142095
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142096
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 310
Qty Limit Days: 31
ID: 142097
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142098
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142099
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142100
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0