CMS Formulary

Displaying 143201-143210 of 1611142 results.
ID: 143201
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 143202
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143203
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143204
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143205
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143206
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 143207
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143208
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143209
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143210
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0