CMS Formulary

Displaying 142561-142570 of 1611142 results.
ID: 142561
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142562
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142563
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142564
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 28
ID: 142565
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 28
ID: 142566
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142567
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142568
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142569
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142570
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0