CMS Formulary

Displaying 143111-143120 of 1611142 results.
ID: 143111
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143112
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242611
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143113
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143114
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143115
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143116
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143117
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143118
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143119
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143120
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31