CMS Formulary

Displaying 142501-142510 of 1611142 results.
ID: 142501
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142502
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142503
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142504
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142505
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142506
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106648
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 130
Qty Limit Days: 31
ID: 142507
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142508
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142509
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1995136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 403
Qty Limit Days: 31
ID: 142510
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0