CMS Formulary

Displaying 140631-140640 of 1611142 results.
ID: 140631
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140632
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140633
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870230
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140634
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870225
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140635
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140636
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140637
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140638
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140639
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140640
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0