CMS Formulary

Displaying 140161-140170 of 1611142 results.
ID: 140161
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 153580
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140162
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404448
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 140163
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2268231
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 140164
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2268227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 28
ID: 140165
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897294
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140166
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 140167
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140168
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140169
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140170
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0