CMS Formulary

Displaying 148681-148690 of 1611142 results.
ID: 148681
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148682
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148683
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148684
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148685
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 148686
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148687
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148688
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148689
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 148690
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0