CMS Formulary

Displaying 143261-143270 of 1611142 results.
ID: 143261
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143262
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143263
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 143264
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143265
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 365
ID: 143266
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143267
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143268
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143269
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143270
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31