CMS Formulary

Displaying 141131-141140 of 1611142 results.
ID: 141131
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141132
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1603845
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141133
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996634
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141134
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996633
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141135
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 141136
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1608333
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141137
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1431977
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141138
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1431982
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141139
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1431987
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141140
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0