CMS Formulary

Displaying 140771-140780 of 1611142 results.
ID: 140771
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1987646
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140772
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140773
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140774
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140775
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659139
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140776
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098608
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140777
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140778
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140779
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 140780
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31