CMS Formulary

Displaying 141101-141110 of 1611142 results.
ID: 141101
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141102
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141103
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1037185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141104
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141105
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141106
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 365
ID: 141107
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141108
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141109
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141110
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31