CMS Formulary

Displaying 148231-148240 of 1611142 results.
ID: 148231
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148232
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148233
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148234
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148235
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148236
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148237
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 148238
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148239
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 148240
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30