CMS Formulary

Displaying 141641-141650 of 1611142 results.
ID: 141641
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141642
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141643
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141644
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 141645
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 141646
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141647
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141648
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141649
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141650
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0