CMS Formulary

Displaying 140361-140370 of 1611142 results.
ID: 140361
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 140362
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488619
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140363
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488617
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140364
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 140365
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140366
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2166143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 140367
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2196900
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140368
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 140369
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1940709
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 140370
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1599852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0