CMS Formulary

Displaying 140541-140550 of 1611142 results.
ID: 140541
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140542
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140543
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140544
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140545
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 757707
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140546
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403957
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140547
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140548
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140549
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 140550
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31