CMS Formulary

Displaying 141191-141200 of 1611142 results.
ID: 141191
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905451
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141192
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141193
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905455
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141194
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966413
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141195
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141196
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141197
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310497
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141198
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141199
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141200
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31