CMS Formulary

Displaying 147571-147580 of 1611142 results.
ID: 147571
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 147572
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 147573
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147574
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1867544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147575
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147576
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107518
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147577
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147578
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 147579
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 147580
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30