CMS Formulary

Displaying 141561-141570 of 1611142 results.
ID: 141561
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141562
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141563
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141564
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141565
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141566
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141567
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141568
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141569
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141570
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 730866
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31