CMS Formulary

Displaying 150641-150650 of 1611142 results.
ID: 150641
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 150642
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600774
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150643
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150644
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600915
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150645
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150646
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 150647
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 150648
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 730834
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150649
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150650
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0