CMS Formulary

Displaying 140751-140760 of 1611142 results.
ID: 140751
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140752
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140753
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140754
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140755
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140756
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140757
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140758
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140759
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140760
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0