CMS Formulary

Displaying 142941-142950 of 1611142 results.
ID: 142941
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142942
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142943
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142944
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142945
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142946
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142947
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142948
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142949
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142950
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31