CMS Formulary

Displaying 141071-141080 of 1611142 results.
ID: 141071
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141072
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141073
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141074
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 206
Qty Limit Days: 31
ID: 141075
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141076
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 138
Qty Limit Days: 31
ID: 141077
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 141078
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 141079
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 141080
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30