CMS Formulary

Displaying 140471-140480 of 1611142 results.
ID: 140471
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140472
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1112250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140473
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140474
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 746804
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 140475
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 746815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 140476
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 746813
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 140477
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 790284
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 140478
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2196792
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 140479
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1536144
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 140480
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1536148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30