CMS Formulary

Displaying 152161-152170 of 1611142 results.
ID: 152161
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 310477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152162
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152163
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152164
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152165
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1863973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152166
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152167
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1863605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152168
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 615099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152169
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 615100
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152170
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 309783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0