CMS Formulary

Displaying 141251-141260 of 1611142 results.
ID: 141251
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857560
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141252
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141253
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141254
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141255
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141256
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141257
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 141258
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 728122
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141259
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141260
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0