CMS Formulary

Displaying 151-160 of 1611142 results.
ID: 151
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 156
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 10
ID: 157
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 159
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 160
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30