CMS Formulary

Displaying 140551-140560 of 1611142 results.
ID: 140551
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140552
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140553
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140554
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140555
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140556
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140557
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140558
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 800915
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140559
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 140560
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30