CMS Formulary

Displaying 141871-141880 of 1611142 results.
ID: 141871
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141872
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141873
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141874
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141875
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141876
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858116
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141877
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 141878
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141879
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141880
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0