CMS Formulary

Displaying 153151-153160 of 1611142 results.
ID: 153151
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153152
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153153
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 602427
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153154
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085736
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153155
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153156
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153157
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153158
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153159
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153160
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0