CMS Formulary

Displaying 141881-141890 of 1611142 results.
ID: 141881
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141882
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141883
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141884
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141885
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141886
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 141887
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141888
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141889
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141890
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0