CMS Formulary

Displaying 140061-140070 of 1611142 results.
ID: 140061
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 140062
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 140063
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 140064
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140065
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140066
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140067
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 74
Qty Limit Days: 31
ID: 140068
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140069
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140070
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0