CMS Formulary

Displaying 148441-148450 of 1611142 results.
ID: 148441
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 148442
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 148443
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 148444
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 148445
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 148446
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 148447
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148448
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148449
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148450
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0