CMS Formulary

Displaying 141721-141730 of 1611142 results.
ID: 141721
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141722
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141723
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 141724
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141725
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141726
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141727
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141728
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141729
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141730
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0