CMS Formulary

Displaying 143431-143440 of 1611142 results.
ID: 143431
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 143432
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143433
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000136
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143434
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 143435
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404475
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143436
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 404476
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143437
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 3
ID: 143438
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143439
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 31
ID: 143440
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 31