CMS Formulary

Displaying 140011-140020 of 1611142 results.
ID: 140011
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 140012
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 140013
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140014
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 140015
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140016
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 140017
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404711
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140018
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762660
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140019
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140020
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2256943
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28