CMS Formulary

Displaying 143871-143880 of 1611142 results.
ID: 143871
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143872
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143873
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143874
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143875
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143876
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143877
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143878
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143879
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 143880
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0