CMS Formulary

Displaying 143491-143500 of 1611142 results.
ID: 143491
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143492
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143493
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143494
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143495
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 433798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143496
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 433800
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143497
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 433799
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 155
Qty Limit Days: 31
ID: 143498
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 433801
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 143499
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143500
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0