CMS Formulary

Displaying 142141-142150 of 1611142 results.
ID: 142141
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142142
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 142143
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142144
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232585
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142145
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1435115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 142146
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 142147
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142148
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142149
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142150
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0