CMS Formulary

Displaying 141661-141670 of 1611142 results.
ID: 141661
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141662
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141663
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190655
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141664
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141665
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 706872
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141666
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244616
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141667
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141668
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308345
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141669
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197636
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141670
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0