CMS Formulary

Displaying 143581-143590 of 1611142 results.
ID: 143581
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377348
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143582
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377350
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143583
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2377352
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143584
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488667
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 143585
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488671
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 143586
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488675
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 143587
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488679
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 521
Qty Limit Days: 31
ID: 143588
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858833
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 261
Qty Limit Days: 31
ID: 143589
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 849866
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143590
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31