CMS Formulary

Displaying 140081-140090 of 1611142 results.
ID: 140081
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140082
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140083
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140084
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140085
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140086
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140087
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140088
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140089
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140090
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28