CMS Formulary

Displaying 142921-142930 of 1611142 results.
ID: 142921
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142922
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142923
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142924
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142925
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142926
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142927
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142928
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142929
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142930
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0