CMS Formulary

Displaying 140801-140810 of 1611142 results.
ID: 140801
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140802
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140803
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 835958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140804
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140805
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140806
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140807
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140808
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1867547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140809
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140810
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738581
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28