CMS Formulary

Displaying 140131-140140 of 1611142 results.
ID: 140131
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140132
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848330
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140133
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140134
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140135
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762833
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140136
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140137
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762839
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140138
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140139
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140140
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0