CMS Formulary

Displaying 142111-142120 of 1611142 results.
ID: 142111
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142112
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142113
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142114
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142115
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142116
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142117
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142118
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142119
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142120
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0