CMS Formulary

Displaying 144121-144130 of 1611142 results.
ID: 144121
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144122
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2059292
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144123
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2059280
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144124
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144125
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144126
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144127
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144128
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144129
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 966607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144130
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0