CMS Formulary

Displaying 141761-141770 of 1611142 results.
ID: 141761
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854140
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141762
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141763
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141764
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141765
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141766
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141767
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141768
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141769
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141770
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0