CMS Formulary

Displaying 145391-145400 of 1611142 results.
ID: 145391
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 388525
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 30
ID: 145392
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 360507
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 145393
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145394
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145395
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145396
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 892494
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 145397
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 892596
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 145398
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 892345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 145399
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 894801
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 145400
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 892352
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30