CMS Formulary

Displaying 141061-141070 of 1611142 results.
ID: 141061
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 403
Qty Limit Days: 31
ID: 141062
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141063
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141064
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141065
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141066
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141067
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141068
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141069
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141070
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31