CMS Formulary

Displaying 148111-148120 of 1611142 results.
ID: 148111
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 148112
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 148113
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 148114
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 148115
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123314
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148116
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2121096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 148117
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2121100
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148118
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148119
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148120
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0