CMS Formulary

Displaying 142431-142440 of 1611142 results.
ID: 142431
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966577
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142432
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142433
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142434
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142435
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142436
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142437
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 142438
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142439
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142440
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0