CMS Formulary

Displaying 144161-144170 of 1611142 results.
ID: 144161
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2104341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 56
ID: 144162
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1724446
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 144163
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2198966
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144164
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197890
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144165
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144166
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144167
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144168
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144169
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144170
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31