CMS Formulary

Displaying 146131-146140 of 1611142 results.
ID: 146131
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 146132
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 146133
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 146134
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 146135
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146136
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 146137
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 146138
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 146139
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 146140
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0