CMS Formulary

Displaying 142771-142780 of 1611142 results.
ID: 142771
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142772
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142773
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142774
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142775
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 142776
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 142777
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 56
ID: 142778
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 142779
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 142780
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28