CMS Formulary

Displaying 144871-144880 of 1611142 results.
ID: 144871
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144872
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144873
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144874
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 144875
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 144876
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 144877
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144878
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144879
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 144880
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30