CMS Formulary

Displaying 140251-140260 of 1611142 results.
ID: 140251
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140252
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140253
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140254
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140255
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140256
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 603978
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140257
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1047508
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140258
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213729
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140259
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140260
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206792
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0