CMS Formulary

Displaying 144651-144660 of 1611142 results.
ID: 144651
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144652
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144653
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 757707
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144654
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 403957
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144655
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144656
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144657
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144658
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144659
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144660
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0