CMS Formulary

Displaying 149151-149160 of 1611142 results.
ID: 149151
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149152
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 149153
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149154
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149155
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149156
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149157
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149158
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149159
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149160
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0