CMS Formulary

Displaying 142601-142610 of 1611142 results.
ID: 142601
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142602
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206791
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142603
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 580286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142604
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551886
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142605
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551884
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142606
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1148145
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 142607
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597570
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142608
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1864414
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142609
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1431083
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142610
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1666385
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31