CMS Formulary

Displaying 151201-151210 of 1611142 results.
ID: 151201
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151202
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151203
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151204
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151205
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151206
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151207
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151208
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 198037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151209
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151210
Formulary ID: 00021061
Formulary Version: 15
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30