CMS Formulary

Displaying 140191-140200 of 1611142 results.
ID: 140191
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140192
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 991722
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140193
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140194
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 140195
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 140196
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 140197
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140198
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140199
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140200
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31