CMS Formulary

Displaying 143461-143470 of 1611142 results.
ID: 143461
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143462
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143463
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143464
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143465
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143466
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143467
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143468
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28
ID: 143469
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 143470
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 28