CMS Formulary

Displaying 140871-140880 of 1611142 results.
ID: 140871
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140872
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140873
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140874
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140875
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140876
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140877
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1863973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140878
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140879
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1863605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140880
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 615099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0