CMS Formulary

Displaying 148151-148160 of 1611142 results.
ID: 148151
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148152
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148153
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148154
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 110
Qty Limit Days: 30
ID: 148155
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148156
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148157
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148158
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148159
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148160
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0