CMS Formulary

Displaying 144361-144370 of 1611142 results.
ID: 144361
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144362
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144363
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144364
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144365
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144366
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144367
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 144368
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 144369
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 144370
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0