CMS Formulary

Displaying 152951-152960 of 1611142 results.
ID: 152951
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152952
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 93
Qty Limit Days: 31
ID: 152953
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 152954
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152955
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152956
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152957
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152958
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152959
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 152960
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0