CMS Formulary

Displaying 141151-141160 of 1611142 results.
ID: 141151
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141152
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 141153
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141154
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141155
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 882548
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141156
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141157
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141158
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141159
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141160
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0