CMS Formulary

Displaying 141851-141860 of 1611142 results.
ID: 141851
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141852
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141853
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141854
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141855
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141856
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141857
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141858
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141859
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141860
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0