CMS Formulary

Displaying 140991-141000 of 1611142 results.
ID: 140991
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606349
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140992
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140993
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140994
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140995
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140996
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284204
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 140997
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140998
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140999
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966793
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141000
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0