CMS Formulary

Displaying 142441-142450 of 1611142 results.
ID: 142441
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142442
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 896110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142443
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 829539
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142444
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142445
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246096
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142446
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142447
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 722111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142448
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 142449
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1376338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142450
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0