CMS Formulary

Displaying 151881-151890 of 1611142 results.
ID: 151881
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151882
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151883
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151884
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 151885
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 800915
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 151886
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 151887
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 151888
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918203
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 151889
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 151890
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28