CMS Formulary

Displaying 144031-144040 of 1611142 results.
ID: 144031
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144032
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144033
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144034
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144035
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144036
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144037
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2107518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31
ID: 144038
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144039
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144040
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31