CMS Formulary

Displaying 142071-142080 of 1611142 results.
ID: 142071
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142072
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 28
ID: 142073
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142074
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235049
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142075
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368392
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142076
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 705129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142077
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368385
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142078
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142079
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142080
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597120
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0