CMS Formulary

Displaying 143901-143910 of 1611142 results.
ID: 143901
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143902
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 866905
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143903
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1041518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143904
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 751553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143905
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143906
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143907
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 349462
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 143908
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143909
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143910
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0