CMS Formulary

Displaying 143501-143510 of 1611142 results.
ID: 143501
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143502
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143503
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143504
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143505
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 849398
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143506
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 849431
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143507
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 143508
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143509
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143510
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0