CMS Formulary

Displaying 149771-149780 of 1611142 results.
ID: 149771
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149772
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149773
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 149774
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 149775
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149776
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 149777
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 51
Qty Limit Days: 30
ID: 149778
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149779
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 149780
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0