CMS Formulary

Displaying 151451-151460 of 1611142 results.
ID: 151451
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 151452
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151453
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 151454
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151455
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151456
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151457
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 151458
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 151459
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 151460
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28