CMS Formulary

Displaying 140731-140740 of 1611142 results.
ID: 140731
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140732
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140733
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140734
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140735
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140736
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140737
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859088
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 140738
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140739
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140740
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30