CMS Formulary

Displaying 148821-148830 of 1611142 results.
ID: 148821
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148822
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148823
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148824
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 148825
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 148826
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 148827
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 148828
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148829
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 148830
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0