CMS Formulary

Displaying 141771-141780 of 1611142 results.
ID: 141771
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141772
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141773
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141774
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141775
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141776
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141777
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141778
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 141779
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 141780
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284205
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28