CMS Formulary

Displaying 142351-142360 of 1611142 results.
ID: 142351
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 142352
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 84
ID: 142353
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1811011
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142354
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1811007
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142355
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1811003
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142356
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1810999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142357
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142358
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142359
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 142360
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0