CMS Formulary

Displaying 150701-150710 of 1611142 results.
ID: 150701
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150702
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150703
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150704
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150705
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150706
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150707
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150708
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1920
Qty Limit Days: 30
ID: 150709
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 150710
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0