CMS Formulary

Displaying 140561-140570 of 1611142 results.
ID: 140561
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918203
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 140562
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 140563
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 140564
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140565
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309047
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140566
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140567
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140568
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140569
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140570
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 279
Qty Limit Days: 31