CMS Formulary

Displaying 142851-142860 of 1611142 results.
ID: 142851
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142852
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142853
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142854
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142855
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142856
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142857
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 104206
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142858
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1998774
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 142859
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1998772
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 30
ID: 142860
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876609
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31