CMS Formulary

Displaying 142291-142300 of 1611142 results.
ID: 142291
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31
ID: 142292
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 142293
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142294
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 142295
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 217
Qty Limit Days: 31
ID: 142296
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142297
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142298
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142299
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 365
ID: 142300
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 365