CMS Formulary

Displaying 143151-143160 of 1611142 results.
ID: 143151
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 143152
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 143153
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143154
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 143155
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143156
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143157
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143158
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143159
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143160
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0