CMS Formulary

Displaying 144721-144730 of 1611142 results.
ID: 144721
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144722
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197975
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144723
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 144724
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1303736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 144725
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144726
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144727
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144728
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144729
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144730
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0