CMS Formulary

Displaying 143351-143360 of 1611142 results.
ID: 143351
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 143352
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 143353
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 143354
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143355
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143356
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143357
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368409
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143358
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368416
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143359
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368423
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143360
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368036
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31