CMS Formulary

Displaying 141501-141510 of 1611142 results.
ID: 141501
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207249
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141502
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966820
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141503
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 795918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141504
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141505
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141506
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141507
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141508
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141509
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141510
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0