CMS Formulary

Displaying 142731-142740 of 1611142 results.
ID: 142731
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142732
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142733
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142734
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142735
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142736
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142737
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142738
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142739
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142740
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0