CMS Formulary

Displaying 143921-143930 of 1611142 results.
ID: 143921
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 885131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143922
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143923
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1249617
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 403
Qty Limit Days: 31
ID: 143924
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143925
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 31
ID: 143926
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143927
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143928
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013662
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143929
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143930
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0