CMS Formulary

Displaying 153281-153290 of 1611142 results.
ID: 153281
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153282
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153283
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153284
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 153285
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153286
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153287
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153288
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153289
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153290
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0