CMS Formulary

Displaying 140411-140420 of 1611142 results.
ID: 140411
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866303
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140412
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140413
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140414
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 140415
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140416
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140417
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140418
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 860244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 140419
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 140420
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31