CMS Formulary

Displaying 143081-143090 of 1611142 results.
ID: 143081
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 143082
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143083
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143084
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143085
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143086
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143087
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143088
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143089
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143090
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0