CMS Formulary

Displaying 150431-150440 of 1611142 results.
ID: 150431
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150432
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150433
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 404587
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150434
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 850
Qty Limit Days: 30
ID: 150435
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 639888
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150436
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744003
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150437
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150438
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744011
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 150439
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150440
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30