CMS Formulary

Displaying 152101-152110 of 1611142 results.
ID: 152101
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 835958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152102
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152103
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152104
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152105
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152106
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1867547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152107
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152108
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 608934
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152109
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152110
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 832718
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0