CMS Formulary

Displaying 143031-143040 of 1611142 results.
ID: 143031
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143032
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143033
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143034
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143035
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143036
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143037
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143038
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 849827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143039
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143040
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0