CMS Formulary

Displaying 142511-142520 of 1611142 results.
ID: 142511
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142512
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2122343
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142513
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142514
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142515
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668363
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142516
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668364
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142517
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668365
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 119
Qty Limit Days: 31
ID: 142518
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668366
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 79
Qty Limit Days: 31
ID: 142519
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 59
Qty Limit Days: 31
ID: 142520
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0