CMS Formulary

Displaying 142281-142290 of 1611142 results.
ID: 142281
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142282
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142283
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142284
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142285
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 142286
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142287
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142288
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 279
Qty Limit Days: 31
ID: 142289
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 279
Qty Limit Days: 31
ID: 142290
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31