CMS Formulary

Displaying 144011-144020 of 1611142 results.
ID: 144011
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144012
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144013
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144014
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197854
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144015
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206971
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144016
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206969
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144017
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2393593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 144018
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 201912
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144019
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373008
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144020
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0