CMS Formulary

Displaying 144971-144980 of 1611142 results.
ID: 144971
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 144972
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 144973
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144974
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144975
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144976
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 876529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144977
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144978
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144979
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 144980
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 966221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0