CMS Formulary

Displaying 143191-143200 of 1611142 results.
ID: 143191
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143192
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143193
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143194
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143195
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143196
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143197
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143198
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143199
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143200
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0