CMS Formulary

Displaying 142611-142620 of 1611142 results.
ID: 142611
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1431104
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142612
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142613
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142614
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1747181
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142615
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441413
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142616
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1747187
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142617
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441418
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142618
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1747194
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142619
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441424
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142620
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0