CMS Formulary

Displaying 141521-141530 of 1611142 results.
ID: 141521
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141522
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141523
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141524
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141525
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141526
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141527
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141528
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 889520
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 403
Qty Limit Days: 31
ID: 141529
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1483329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 141530
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1012017
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0