CMS Formulary

Displaying 141931-141940 of 1611142 results.
ID: 141931
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 141932
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904880
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 141933
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 31
ID: 141934
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 31
ID: 141935
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 31
ID: 141936
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141937
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141938
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141939
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141940
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31