CMS Formulary

Displaying 143371-143380 of 1611142 results.
ID: 143371
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143372
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143373
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600774
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143374
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600776
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143375
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600915
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143376
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600917
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143377
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737789
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143378
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 402169
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 143379
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1483679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 143380
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30