CMS Formulary

Displaying 140611-140620 of 1611142 results.
ID: 140611
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140612
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140613
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140614
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140615
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140616
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140617
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 359493
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 140618
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 359494
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 140619
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140620
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0