CMS Formulary

Displaying 141391-141400 of 1611142 results.
ID: 141391
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141392
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141393
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141394
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141395
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141396
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141397
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141398
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141399
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141400
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28