CMS Formulary

Displaying 142331-142340 of 1611142 results.
ID: 142331
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 142332
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 142333
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 142334
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 142335
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1545166
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142336
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1545163
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142337
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1545159
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142338
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1545156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142339
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 142340
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28