CMS Formulary

Displaying 143341-143350 of 1611142 results.
ID: 143341
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143342
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809513
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143343
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143344
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143345
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143346
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143347
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143348
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143349
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373493
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143350
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373498
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 365