CMS Formulary

Displaying 143481-143490 of 1611142 results.
ID: 143481
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143482
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143483
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143484
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143485
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143486
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143487
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143488
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143489
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143490
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0