CMS Formulary

Displaying 149671-149680 of 1611142 results.
ID: 149671
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149672
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149673
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 149674
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149675
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149676
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149677
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149678
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149679
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149680
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0