CMS Formulary

Displaying 142271-142280 of 1611142 results.
ID: 142271
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043748
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142272
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142273
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142274
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 477367
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142275
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 477372
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142276
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2391560
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 142277
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142278
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1088255
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142279
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1088251
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142280
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1088253
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31