CMS Formulary

Displaying 145011-145020 of 1611142 results.
ID: 145011
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 145012
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 145013
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145014
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145015
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145016
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 359144
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145017
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145018
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145019
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145020
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606349
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0