CMS Formulary

Displaying 141171-141180 of 1611142 results.
ID: 141171
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31
ID: 141172
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141173
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141174
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141175
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141176
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 28
ID: 141177
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141178
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141179
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141180
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0