CMS Formulary

Displaying 143401-143410 of 1611142 results.
ID: 143401
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143402
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143403
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143404
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143405
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 143406
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143407
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143408
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351254
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143409
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143410
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0