CMS Formulary

Displaying 140581-140590 of 1611142 results.
ID: 140581
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140582
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 279
Qty Limit Days: 31
ID: 140583
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 279
Qty Limit Days: 31
ID: 140584
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140585
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140586
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140587
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140588
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140589
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140590
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235267
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0