CMS Formulary

Displaying 146241-146250 of 1611142 results.
ID: 146241
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146242
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 146243
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 146244
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 146245
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 146246
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146247
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 146248
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146249
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146250
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0