CMS Formulary

Displaying 142341-142350 of 1611142 results.
ID: 142341
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 142342
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 142343
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 142344
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142345
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 52
Qty Limit Days: 31
ID: 142346
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142347
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142348
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 51
Qty Limit Days: 30
ID: 142349
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 142350
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84