CMS Formulary

Displaying 144191-144200 of 1611142 results.
ID: 144191
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 144192
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 144193
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 144194
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2282414
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144195
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283236
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144196
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144197
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144198
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 144199
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 144200
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28