CMS Formulary

Displaying 142191-142200 of 1611142 results.
ID: 142191
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142192
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142193
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142194
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142195
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142196
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142197
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142198
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142199
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142200
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0