CMS Formulary

Displaying 140031-140040 of 1611142 results.
ID: 140031
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140032
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140033
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140034
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736863
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140035
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 140036
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926331
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140037
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140038
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140039
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140040
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311036
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0