CMS Formulary

Displaying 143671-143680 of 1611142 results.
ID: 143671
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013665
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143672
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013659
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143673
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143674
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 930
Qty Limit Days: 31
ID: 143675
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143676
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143677
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143678
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 629699
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143679
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 629695
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143680
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 629697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0