CMS Formulary

Displaying 140071-140080 of 1611142 results.
ID: 140071
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140072
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352297
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140073
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 731328
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140074
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140075
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140076
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140077
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140078
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140079
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140080
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31