CMS Formulary

Displaying 140781-140790 of 1611142 results.
ID: 140781
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198057
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140782
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140783
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140784
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140785
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140786
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140787
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140788
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140789
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140790
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0