CMS Formulary

Displaying 142681-142690 of 1611142 results.
ID: 142681
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207949
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142682
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2286281
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142683
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2286290
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142684
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2286285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142685
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2396905
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 142686
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142687
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352045
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142688
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142689
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352047
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142690
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654955
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0