CMS Formulary

Displaying 142661-142670 of 1611142 results.
ID: 142661
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142662
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 142663
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 994008
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142664
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 900156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142665
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848582
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142666
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 824959
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142667
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142668
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142669
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142670
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0