CMS Formulary

Displaying 143321-143330 of 1611142 results.
ID: 143321
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143322
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143323
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143324
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143325
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143326
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143327
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 695935
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143328
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143329
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668622
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 143330
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31