CMS Formulary

Displaying 143451-143460 of 1611142 results.
ID: 143451
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143452
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143453
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143454
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143455
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143456
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143457
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143458
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143459
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 180
ID: 143460
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0