CMS Formulary

Displaying 149301-149310 of 1611142 results.
ID: 149301
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149302
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149303
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149304
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149305
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149306
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149307
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149308
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149309
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149310
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30