CMS Formulary

Displaying 142781-142790 of 1611142 results.
ID: 142781
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 142782
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1100075
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142783
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142784
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142785
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142786
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 142787
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142788
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142789
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142790
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539248
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0