CMS Formulary

Displaying 146221-146230 of 1611142 results.
ID: 146221
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 146222
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 146223
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 146224
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 146225
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 146226
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 201185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146227
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 146228
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 146229
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 146230
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30