CMS Formulary

Displaying 150291-150300 of 1611142 results.
ID: 150291
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150292
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150293
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150294
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150295
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150296
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150297
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150298
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150299
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 150300
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0