CMS Formulary

Displaying 143651-143660 of 1611142 results.
ID: 143651
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143652
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143653
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143654
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485489
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143655
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143656
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143657
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 143658
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143659
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143660
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31