CMS Formulary

Displaying 144061-144070 of 1611142 results.
ID: 144061
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054269
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 365
ID: 144062
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2362178
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144063
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2362182
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144064
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 144065
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 144066
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 997006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144067
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 997007
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144068
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 884383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144069
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144070
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30