CMS Formulary

Displaying 142391-142400 of 1611142 results.
ID: 142391
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142392
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142393
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142394
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 142395
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 142396
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 142397
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 201185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142398
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31
ID: 142399
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142400
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28