CMS Formulary

Displaying 141001-141010 of 1611142 results.
ID: 141001
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141002
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141003
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 208332
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141004
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 208327
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141005
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141006
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141007
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141008
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141009
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141010
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30