CMS Formulary

Displaying 140341-140350 of 1611142 results.
ID: 140341
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140342
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994395
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140343
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994389
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140344
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994392
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140345
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313884
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140346
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855871
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140347
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140348
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140349
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140350
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28