CMS Formulary

Displaying 147631-147640 of 1611142 results.
ID: 147631
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 147632
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 147633
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 147634
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 147635
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 147636
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 147637
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 147638
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147639
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2104341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 147640
Formulary ID: 00021060
Formulary Version: 14
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30