CMS Formulary

Displaying 147121-147130 of 1611142 results.
ID: 147121
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 849431
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147122
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 861783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 147123
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147124
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147125
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147126
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147127
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147128
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147129
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147130
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30