CMS Formulary

Displaying 150131-150140 of 1611142 results.
ID: 150131
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 150132
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 150133
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 150134
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 150135
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 150136
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 150137
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 150138
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 150139
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 150140
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1