CMS Formulary

Displaying 141531-141540 of 1611142 results.
ID: 141531
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 141532
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 141533
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141534
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141535
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141536
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141537
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 341
Qty Limit Days: 31
ID: 141538
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141539
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 403
Qty Limit Days: 31
ID: 141540
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 403
Qty Limit Days: 31