CMS Formulary

Displaying 141301-141310 of 1611142 results.
ID: 141301
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141302
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996572
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141303
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141304
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141305
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141306
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141307
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31
ID: 141308
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141309
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141310
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0