CMS Formulary

Displaying 143331-143340 of 1611142 results.
ID: 143331
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668626
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 119
Qty Limit Days: 31
ID: 143332
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668628
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 79
Qty Limit Days: 31
ID: 143333
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 668630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 59
Qty Limit Days: 31
ID: 143334
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442681
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143335
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442683
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143336
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2101459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143337
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2101465
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143338
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011705
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 143339
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 867381
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143340
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926823
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0