CMS Formulary

Displaying 140661-140670 of 1611142 results.
ID: 140661
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140662
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140663
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140664
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140665
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140666
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140667
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140668
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140669
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140670
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0