CMS Formulary

Displaying 142811-142820 of 1611142 results.
ID: 142811
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28
ID: 142812
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 142813
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 142814
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142815
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142816
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142817
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142818
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142819
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142820
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0