CMS Formulary

Displaying 140381-140390 of 1611142 results.
ID: 140381
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140382
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140383
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966271
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140384
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140385
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140386
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 140387
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 140388
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966158
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140389
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140390
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966171
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0