CMS Formulary

Displaying 145041-145050 of 1611142 results.
ID: 145041
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 145042
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145043
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145044
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145045
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 728550
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 145046
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145047
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 145048
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145049
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145050
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0