CMS Formulary

Displaying 142541-142550 of 1611142 results.
ID: 142541
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142542
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142543
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142544
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142545
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142546
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142547
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 142548
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 136
Qty Limit Days: 12
ID: 142549
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 844590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142550
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 844813
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0