CMS Formulary

Displaying 146931-146940 of 1611142 results.
ID: 146931
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 146932
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 146933
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146934
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146935
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 146936
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146937
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146938
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 146939
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 483427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 146940
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 483425
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0