CMS Formulary

Displaying 142321-142330 of 1611142 results.
ID: 142321
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142322
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 310
Qty Limit Days: 31
ID: 142323
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142324
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1483554
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142325
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142326
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 402252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142327
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 142328
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142329
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373469
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142330
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373473
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31