CMS Formulary

Displaying 144221-144230 of 1611142 results.
ID: 144221
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144222
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144223
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144224
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2475406
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 144225
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144226
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144227
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144228
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1100070
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 144229
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 994010
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 144230
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 994007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31