CMS Formulary

Displaying 140491-140500 of 1611142 results.
ID: 140491
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 140492
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140493
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140494
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140495
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140496
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140497
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140498
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140499
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140500
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0