CMS Formulary

Displaying 142631-142640 of 1611142 results.
ID: 142631
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142632
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142633
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142634
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142635
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142636
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312132
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142637
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142638
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142639
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142640
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31