CMS Formulary

Displaying 142711-142720 of 1611142 results.
ID: 142711
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 55
Qty Limit Days: 28
ID: 142712
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 212218
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142713
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649946
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142714
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142715
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 142716
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142717
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 142718
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142719
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 28
ID: 142720
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28