CMS Formulary

Displaying 143811-143820 of 1611142 results.
ID: 143811
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143812
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143813
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143814
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143815
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143816
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143817
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143818
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 143819
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 143820
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0