CMS Formulary

Displaying 141011-141020 of 1611142 results.
ID: 141011
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141012
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141013
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141014
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141015
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141016
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141017
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 141018
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141019
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141020
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0