CMS Formulary

Displaying 146021-146030 of 1611142 results.
ID: 146021
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146022
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146023
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146024
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146025
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146026
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 146027
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 146028
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001430
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146029
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146030
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2043464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0