CMS Formulary

Displaying 141611-141620 of 1611142 results.
ID: 141611
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141612
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141613
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 28
ID: 141614
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141615
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141616
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141617
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141618
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141619
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141620
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0