CMS Formulary

Displaying 141401-141410 of 1611142 results.
ID: 141401
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657173
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 141402
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 141403
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141404
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 141405
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141406
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141407
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141408
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141409
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141410
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0