CMS Formulary

Displaying 141291-141300 of 1611142 results.
ID: 141291
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141292
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141293
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141294
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141295
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 828299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141296
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141297
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141298
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857564
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141299
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141300
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0