CMS Formulary

Displaying 141941-141950 of 1611142 results.
ID: 141941
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141942
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141943
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141944
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141945
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 365
ID: 141946
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141947
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 158
Qty Limit Days: 31
ID: 141948
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 141949
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141950
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0