CMS Formulary

Displaying 140291-140300 of 1611142 results.
ID: 140291
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140292
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140293
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140294
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140295
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140296
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140297
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2469340
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140298
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307431
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 31
ID: 140299
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140300
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30