CMS Formulary

Displaying 142951-142960 of 1611142 results.
ID: 142951
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142952
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142953
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142954
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142955
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142956
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307427
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 31
ID: 142957
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142958
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142959
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142960
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198318
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0