CMS Formulary

Displaying 141891-141900 of 1611142 results.
ID: 141891
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 791
Qty Limit Days: 31
ID: 141892
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199026
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141893
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199030
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141894
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 825005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141895
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141896
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141897
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 984105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141898
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141899
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141900
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0