CMS Formulary

Displaying 144611-144620 of 1611142 results.
ID: 144611
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144612
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144613
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144614
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144615
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144616
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144617
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144618
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144619
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144620
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 44
Qty Limit Days: 30