CMS Formulary

Displaying 142741-142750 of 1611142 results.
ID: 142741
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142742
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142743
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142744
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142745
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142746
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31
ID: 142747
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142748
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142749
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142750
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0