CMS Formulary

Displaying 142641-142650 of 1611142 results.
ID: 142641
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142642
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142643
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 994005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142644
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142645
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142646
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142647
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142648
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403841
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142649
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142650
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0