CMS Formulary

Displaying 152111-152120 of 1611142 results.
ID: 152111
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152112
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152113
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152114
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 152115
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152116
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152117
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152118
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152119
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152120
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0