CMS Formulary

Displaying 140041-140050 of 1611142 results.
ID: 140041
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847252
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140042
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311026
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140043
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 140044
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140045
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 106892
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140046
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847254
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140047
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847213
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140048
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652640
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140049
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847189
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140050
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847199
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0