CMS Formulary

Displaying 140261-140270 of 1611142 results.
ID: 140261
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207850
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140262
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140263
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 208821
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140264
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011080
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140265
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213307
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140266
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 211020
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140267
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 213320
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140268
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 804547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140269
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140270
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0