CMS Formulary

Displaying 141321-141330 of 1611142 results.
ID: 141321
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 141322
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 141323
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 141324
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 141325
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141326
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141327
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141328
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141329
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141330
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31