CMS Formulary

Displaying 143791-143800 of 1611142 results.
ID: 143791
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143792
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 143793
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143794
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143795
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143796
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143797
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1487251
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 372
Qty Limit Days: 31
ID: 143798
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143799
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143800
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0