CMS Formulary

Displaying 141141-141150 of 1611142 results.
ID: 141141
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141142
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 141143
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141144
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141145
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141146
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861385
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141147
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861381
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141148
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141149
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141150
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0