CMS Formulary

Displaying 143511-143520 of 1611142 results.
ID: 143511
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143512
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143513
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143514
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143515
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143516
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143517
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143518
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143519
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143520
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31