CMS Formulary

Displaying 145021-145030 of 1611142 results.
ID: 145021
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 145022
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 145023
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 145024
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 145025
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145026
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145027
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 966787
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145028
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 966793
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145029
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145030
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0