CMS Formulary

Displaying 140481-140490 of 1611142 results.
ID: 140481
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140482
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140483
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140484
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140485
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140486
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140487
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855178
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140488
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140489
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140490
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0