CMS Formulary

Displaying 146711-146720 of 1611142 results.
ID: 146711
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 146712
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 146713
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146714
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146715
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146716
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146717
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146718
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146719
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146720
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0