CMS Formulary

Displaying 140741-140750 of 1611142 results.
ID: 140741
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 140742
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140743
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140744
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 140745
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 140746
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140747
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213557
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140748
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140749
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140750
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0