CMS Formulary

Displaying 142701-142710 of 1611142 results.
ID: 142701
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142702
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352262
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142703
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731229
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142704
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142705
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142706
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205923
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142707
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142708
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 727545
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142709
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142710
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205912
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0