CMS Formulary

Displaying 143131-143140 of 1611142 results.
ID: 143131
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744003
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143132
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744007
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143133
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744011
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143134
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 722124
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143135
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 722120
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143136
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143137
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143138
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143139
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143140
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28