CMS Formulary

Displaying 143701-143710 of 1611142 results.
ID: 143701
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143702
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143703
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143704
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143705
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143706
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143707
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143708
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143709
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143710
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349420
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31