CMS Formulary

Displaying 142301-142310 of 1611142 results.
ID: 142301
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142302
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142303
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5167
Qty Limit Days: 31
ID: 142304
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142305
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142306
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 578018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142307
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142308
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 142309
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142310
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0