CMS Formulary

Displaying 144171-144180 of 1611142 results.
ID: 144171
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144172
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144173
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144174
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144175
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099323
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 144176
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144177
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144178
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144179
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144180
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31