CMS Formulary

Displaying 144151-144160 of 1611142 results.
ID: 144151
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2056498
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144152
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2056502
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144153
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2056506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144154
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2056510
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144155
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855628
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144156
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144157
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399654
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144158
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399658
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144159
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144160
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054275
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28