CMS Formulary

Displaying 140961-140970 of 1611142 results.
ID: 140961
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140962
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140963
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 790489
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140964
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140965
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140966
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140967
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140968
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140969
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 360344
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140970
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0