CMS Formulary

Displaying 153061-153070 of 1611142 results.
ID: 153061
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 31
ID: 153062
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 31
ID: 153063
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 153064
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153065
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 153066
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 153067
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 153068
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 153069
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 153070
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31