CMS Formulary

Displaying 140151-140160 of 1611142 results.
ID: 140151
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 864820
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 140152
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190955
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140153
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190957
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140154
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140155
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140156
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140157
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140158
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140159
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140160
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 153579
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0