CMS Formulary

Displaying 143971-143980 of 1611142 results.
ID: 143971
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143972
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143973
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143974
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143975
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 143976
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485423
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143977
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 485421
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 143978
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143979
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143980
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 365