CMS Formulary

Displaying 141741-141750 of 1611142 results.
ID: 141741
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 686405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141742
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141743
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141744
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206080
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141745
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 686402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141746
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2361313
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141747
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1426251
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141748
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1425339
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141749
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1426253
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141750
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1425337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31