CMS Formulary

Displaying 142591-142600 of 1611142 results.
ID: 142591
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 852920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142592
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142593
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142594
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142595
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142596
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858778
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 142597
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142598
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142599
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142600
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0