CMS Formulary

Displaying 140371-140380 of 1611142 results.
ID: 140371
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1483340
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140372
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597388
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 140373
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140374
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140375
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 670031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140376
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140377
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140378
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140379
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140380
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0