CMS Formulary

Displaying 143571-143580 of 1611142 results.
ID: 143571
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143572
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143573
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143574
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729047
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143575
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729076
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 365
ID: 143576
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377354
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143577
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377338
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143578
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377342
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143579
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377344
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143580
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377346
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0