CMS Formulary

Displaying 144081-144090 of 1611142 results.
ID: 144081
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 808917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144082
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1941470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144083
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1941476
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144084
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1941473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144085
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144086
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144087
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144088
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144089
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144090
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2059266
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0