CMS Formulary

Displaying 145681-145690 of 1611142 results.
ID: 145681
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145682
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 200193
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 145683
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 200194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 145684
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145685
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145686
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145687
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145688
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145689
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1043025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145690
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1043031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0