CMS Formulary

Displaying 141861-141870 of 1611142 results.
ID: 141861
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141862
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141863
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141864
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141865
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141866
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141867
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141868
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141869
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141870
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861822
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31