CMS Formulary

Displaying 140001-140010 of 1611142 results.
ID: 140001
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140002
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140003
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 967021
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140004
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1248442
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140005
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140006
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140007
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 140008
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 140009
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140010
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28