CMS Formulary

Displaying 141691-141700 of 1611142 results.
ID: 141691
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 141692
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 141693
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141694
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141695
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141696
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141697
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141698
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141699
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141700
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0