CMS Formulary

Displaying 144051-144060 of 1611142 results.
ID: 144051
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144052
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144053
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2261403
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5723
Qty Limit Days: 31
ID: 144054
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144055
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 144056
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 144057
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1365979
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144058
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1537045
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144059
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144060
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31