CMS Formulary

Displaying 140301-140310 of 1611142 results.
ID: 140301
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140302
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 106
Qty Limit Days: 365
ID: 140303
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 140304
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140305
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140306
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140307
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 140308
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140309
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140310
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0