CMS Formulary

Displaying 142371-142380 of 1611142 results.
ID: 142371
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142372
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 142373
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142374
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 28
ID: 142375
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 994226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2582
Qty Limit Days: 31
ID: 142376
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142377
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142378
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899521
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142379
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142380
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899607
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0