CMS Formulary

Displaying 145351-145360 of 1611142 results.
ID: 145351
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145352
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145353
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 145354
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657173
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 145355
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 145356
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145357
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 145358
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145359
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145360
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0