CMS Formulary

Displaying 143591-143600 of 1611142 results.
ID: 143591
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352119
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143592
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352120
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143593
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 352121
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143594
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143595
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143596
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 143597
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143598
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 242120
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143599
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652639
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143600
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 628958
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0