CMS Formulary

Displaying 143661-143670 of 1611142 results.
ID: 143661
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143662
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143663
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 637173
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143664
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 143665
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 143666
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143667
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143668
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143669
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143670
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0