CMS Formulary

Displaying 144241-144250 of 1611142 results.
ID: 144241
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144242
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 144243
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144244
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144245
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144246
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144247
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144248
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144249
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144250
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0