CMS Formulary

Displaying 141811-141820 of 1611142 results.
ID: 141811
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141812
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 672908
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141813
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 672910
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141814
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 672909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141815
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141816
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141817
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141818
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141819
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141820
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0