CMS Formulary

Displaying 148641-148650 of 1611142 results.
ID: 148641
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 148642
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 148643
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 884535
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 148644
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 884532
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 148645
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 148646
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 148647
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 148648
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 148649
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148650
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0