CMS Formulary

Displaying 143441-143450 of 1611142 results.
ID: 143441
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 31
ID: 143442
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 636141
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143443
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 637216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143444
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 143445
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 143446
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 143447
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 143448
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 143449
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143450
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0