CMS Formulary

Displaying 152051-152060 of 1611142 results.
ID: 152051
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 152052
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 152053
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 152054
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 152055
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 152056
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 152057
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 152058
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 152059
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152060
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0