CMS Formulary

Displaying 143711-143720 of 1611142 results.
ID: 143711
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 143712
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 248
Qty Limit Days: 31
ID: 143713
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143714
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143715
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143716
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143717
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143718
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143719
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 616402
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143720
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0