CMS Formulary

Displaying 142841-142850 of 1611142 results.
ID: 142841
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 849835
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142842
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142843
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142844
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142845
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142846
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142847
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142848
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 142849
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 142850
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0