CMS Formulary

Displaying 144791-144800 of 1611142 results.
ID: 144791
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144792
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144793
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144794
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144795
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 144796
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 144797
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 144798
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144799
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144800
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0