CMS Formulary

Displaying 151431-151440 of 1611142 results.
ID: 151431
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 74
Qty Limit Days: 31
ID: 151432
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 151433
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 151434
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 151435
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 151436
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151437
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151438
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 74
Qty Limit Days: 31
ID: 151439
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151440
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0