CMS Formulary

Displaying 142201-142210 of 1611142 results.
ID: 142201
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142202
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142203
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142204
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142205
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142206
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142207
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142208
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142209
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 577154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142210
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0