CMS Formulary

Displaying 143471-143480 of 1611142 results.
ID: 143471
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143472
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143473
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143474
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143475
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143476
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143477
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143478
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143479
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143480
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31