CMS Formulary

Displaying 146551-146560 of 1611142 results.
ID: 146551
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146552
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146553
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146554
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146555
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146556
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 104206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146557
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1998774
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 146558
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1998772
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 30
ID: 146559
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146560
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0