CMS Formulary

Displaying 141021-141030 of 1611142 results.
ID: 141021
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141022
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141023
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141024
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141025
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141026
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141027
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141028
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141029
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141030
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0