CMS Formulary

Displaying 140841-140850 of 1611142 results.
ID: 140841
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140842
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 140843
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 279
Qty Limit Days: 31
ID: 140844
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 140845
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 140846
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 140847
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140848
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 140849
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140850
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31