CMS Formulary

Displaying 147451-147460 of 1611142 results.
ID: 147451
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147452
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147453
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147454
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147455
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147456
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147457
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147458
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147459
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 861512
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 125
Qty Limit Days: 28
ID: 147460
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 197572
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0