CMS Formulary

Displaying 144211-144220 of 1611142 results.
ID: 144211
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265689
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 144212
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 144213
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311040
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144214
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653196
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144215
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144216
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351297
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144217
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 847191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144218
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 144219
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144220
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0