CMS Formulary

Displaying 145451-145460 of 1611142 results.
ID: 145451
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145452
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145453
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 966920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145454
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 801054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145455
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145456
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145457
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145458
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145459
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145460
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30