CMS Formulary

Displaying 142311-142320 of 1611142 results.
ID: 142311
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142312
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142313
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 212787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142314
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 142315
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142316
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142317
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142318
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142319
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142320
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31