CMS Formulary

Displaying 141911-141920 of 1611142 results.
ID: 141911
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141912
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141913
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141914
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141915
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739337
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 141916
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806200
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141917
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141918
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806202
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141919
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806206
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141920
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806210
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31