CMS Formulary

Displaying 143831-143840 of 1611142 results.
ID: 143831
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143832
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143833
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143834
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143835
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143836
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143837
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143838
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143839
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 143840
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 351134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28