CMS Formulary

Displaying 140791-140800 of 1611142 results.
ID: 140791
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 892342
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140792
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 892349
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140793
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 892355
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140794
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 892297
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 51
Qty Limit Days: 31
ID: 140795
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 894942
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140796
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 894970
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140797
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140798
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140799
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904571
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140800
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0