CMS Formulary

Displaying 145251-145260 of 1611142 results.
ID: 145251
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 145252
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 145253
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 145254
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1375948
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145255
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 145256
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 145257
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145258
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145259
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145260
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0