CMS Formulary

Displaying 144101-144110 of 1611142 results.
ID: 144101
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144102
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144103
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 144104
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1599841
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144105
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 307732
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144106
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144107
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144108
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144109
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2045959
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144110
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2045961
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0