CMS Formulary

Displaying 143851-143860 of 1611142 results.
ID: 143851
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 143852
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 341
Qty Limit Days: 31
ID: 143853
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 186
Qty Limit Days: 31
ID: 143854
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143855
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 143856
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 143857
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143858
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143859
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143860
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0