CMS Formulary

Displaying 145781-145790 of 1611142 results.
ID: 145781
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 145782
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145783
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145784
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145785
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145786
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145787
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145788
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145789
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 145790
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0