CMS Formulary

Displaying 143421-143430 of 1611142 results.
ID: 143421
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143422
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143423
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 143424
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143425
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143426
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143427
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143428
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143429
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143430
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0