CMS Formulary

Displaying 148771-148780 of 1611142 results.
ID: 148771
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 148772
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148773
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 404062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148774
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 643488
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148775
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 404065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148776
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148777
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148778
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148779
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148780
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0