CMS Formulary

Displaying 141991-142000 of 1611142 results.
ID: 141991
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141992
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 141993
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141994
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141995
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141996
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141997
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141998
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 141999
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142000
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 597974
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0