CMS Formulary

Displaying 149471-149480 of 1611142 results.
ID: 149471
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 149472
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149473
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149474
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 149475
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149476
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149477
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149478
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149479
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149480
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 597967
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30