CMS Formulary

Displaying 146121-146130 of 1611142 results.
ID: 146121
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146122
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146123
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146124
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146125
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 146126
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 146127
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 146128
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 146129
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146130
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30