CMS Formulary

Displaying 149681-149690 of 1611142 results.
ID: 149681
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 577776
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149682
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149683
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149684
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149685
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653217
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149686
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149687
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111018
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149688
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 212381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149689
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149690
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0