CMS Formulary

Displaying 147231-147240 of 1611142 results.
ID: 147231
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 147232
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 147233
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 637173
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147234
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28
ID: 147235
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28
ID: 147236
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147237
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147238
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147239
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147240
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0