CMS Formulary

Displaying 141791-141800 of 1611142 results.
ID: 141791
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 884522
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141792
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141793
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141794
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141795
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141796
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141797
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141798
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141799
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141800
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31