CMS Formulary

Displaying 143611-143620 of 1611142 results.
ID: 143611
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143612
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143613
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143614
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 896184
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 143615
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 896209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 143616
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 896228
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 143617
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143618
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143619
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143620
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31