CMS Formulary

Displaying 142961-142970 of 1611142 results.
ID: 142961
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142962
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142963
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142964
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142965
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142966
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142967
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142968
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142969
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1596023
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 142970
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0