CMS Formulary

Displaying 141681-141690 of 1611142 results.
ID: 141681
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1237062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 86
Qty Limit Days: 31
ID: 141682
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1237066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 57
Qty Limit Days: 31
ID: 141683
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1237070
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 43
Qty Limit Days: 31
ID: 141684
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 884526
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141685
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1090641
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141686
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141687
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141688
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141689
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141690
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0