CMS Formulary

Displaying 140891-140900 of 1611142 results.
ID: 140891
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140892
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 204466
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140893
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207391
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140894
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140895
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140896
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1090639
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140897
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140898
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140899
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 801012
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140900
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 801000
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0