CMS Formulary

Displaying 141831-141840 of 1611142 results.
ID: 141831
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141832
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141833
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141834
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141835
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141836
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141837
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141838
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141839
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141840
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0