CMS Formulary

Displaying 152211-152220 of 1611142 results.
ID: 152211
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152212
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152213
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152214
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152215
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152216
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152217
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152218
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152219
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152220
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0