CMS Formulary

Displaying 145131-145140 of 1611142 results.
ID: 145131
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 145132
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145133
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145134
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145135
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145136
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606490
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 145137
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 859983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 145138
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 859979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 145139
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 145140
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1608333
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0