CMS Formulary

Displaying 143981-143990 of 1611142 results.
ID: 143981
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143982
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 143983
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049558
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143984
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143985
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143986
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143987
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143988
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143989
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 198008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 143990
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0