CMS Formulary

Displaying 144021-144030 of 1611142 results.
ID: 144021
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144022
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144023
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144024
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144025
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144026
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144027
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198037
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144028
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144029
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144030
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31