CMS Formulary

Displaying 141051-141060 of 1611142 results.
ID: 141051
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110516
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 141052
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 141053
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141054
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 211343
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141055
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141056
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141057
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141058
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2001565
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141059
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2001566
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141060
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2001568
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31