CMS Formulary

Displaying 140851-140860 of 1611142 results.
ID: 140851
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 56
ID: 140852
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 56
ID: 140853
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858044
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140854
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858040
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 140855
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043567
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140856
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043582
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140857
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043574
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140858
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 140859
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 140860
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0