CMS Formulary

Displaying 150121-150130 of 1611142 results.
ID: 150121
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150122
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 150123
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150124
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150125
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150126
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539248
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150127
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 150128
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 150129
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 150130
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1