CMS Formulary

Displaying 148361-148370 of 1611142 results.
ID: 148361
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 148362
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 148363
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 148364
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148365
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 148366
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 148367
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 148368
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 213557
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148369
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148370
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0