CMS Formulary

Displaying 141031-141040 of 1611142 results.
ID: 141031
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141032
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141033
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141034
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141035
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141036
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 103467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141037
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206212
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141038
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141039
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 141040
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0