CMS Formulary

Displaying 142381-142390 of 1611142 results.
ID: 142381
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899642
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142382
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899705
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142383
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142384
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142385
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142386
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142387
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142388
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142389
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142390
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31