CMS Formulary

Displaying 143541-143550 of 1611142 results.
ID: 143541
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143542
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143543
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143544
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143545
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143546
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143547
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143548
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143549
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143550
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 730869
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31