CMS Formulary

Displaying 142861-142870 of 1611142 results.
ID: 142861
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1593858
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142862
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854832
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142863
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854836
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142864
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142865
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854852
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142866
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854848
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142867
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854844
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 142868
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 142869
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 142870
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28