CMS Formulary

Displaying 140461-140470 of 1611142 results.
ID: 140461
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140462
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 70
Qty Limit Days: 28
ID: 140463
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 140464
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 140465
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 140466
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123314
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 365
ID: 140467
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2121096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 140468
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2121100
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140469
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2390954
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 140470
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0