CMS Formulary

Displaying 144541-144550 of 1611142 results.
ID: 144541
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144542
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144543
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 21
ID: 144544
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 21
ID: 144545
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 21
ID: 144546
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 144547
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 144548
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144549
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 144550
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 672152
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30