CMS Formulary

Displaying 143621-143630 of 1611142 results.
ID: 143621
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143622
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143623
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143624
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 647237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143625
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 647239
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143626
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198313
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143627
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198312
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143628
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 643123
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143629
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 643125
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143630
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 643127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0