CMS Formulary

Displaying 142691-142700 of 1611142 results.
ID: 142691
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731227
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142692
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142693
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 730046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142694
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142695
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731235
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142696
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731241
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142697
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142698
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 656137
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142699
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 706958
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142700
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 706960
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31