CMS Formulary

Displaying 143121-143130 of 1611142 results.
ID: 143121
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143122
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143123
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 365
ID: 143124
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143125
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143126
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143127
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143128
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143129
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143130
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 639888
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0