CMS Formulary

Displaying 141781-141790 of 1611142 results.
ID: 141781
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141782
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141783
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141784
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141785
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141786
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442165
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141787
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442170
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141788
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141789
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 141790
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0