CMS Formulary

Displaying 140201-140210 of 1611142 results.
ID: 140201
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140202
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140203
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140204
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2800
Qty Limit Days: 31
ID: 140205
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1400
Qty Limit Days: 31
ID: 140206
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140207
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140208
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140209
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140210
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0