CMS Formulary

Displaying 141581-141590 of 1611142 results.
ID: 141581
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141582
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141583
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091170
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141584
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091185
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141585
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091210
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141586
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141587
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141588
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141589
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 808748
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141590
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859066
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0