CMS Formulary

Displaying 141671-141680 of 1611142 results.
ID: 141671
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141672
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437280
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141673
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1436245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141674
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141675
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437290
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141676
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1365660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141677
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1365847
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141678
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1365850
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141679
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1237055
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 141680
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1237059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31