CMS Formulary

Displaying 141361-141370 of 1611142 results.
ID: 141361
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 141362
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141363
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141364
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141365
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141366
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141367
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141368
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141369
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141370
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0