CMS Formulary

Displaying 141951-141960 of 1611142 results.
ID: 141951
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141952
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141953
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141954
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091389
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141955
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 141956
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091152
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 141957
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232202
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141958
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 141959
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141960
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 31