CMS Formulary

Displaying 142571-142580 of 1611142 results.
ID: 142571
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142572
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142573
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142574
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1495316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142575
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1998631
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142576
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2179635
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142577
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142578
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 558
Qty Limit Days: 31
ID: 142579
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142580
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0