CMS Formulary

Displaying 153441-153450 of 1611142 results.
ID: 153441
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 899660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153442
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 899521
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153443
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 899690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153444
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 899607
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153445
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 899642
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153446
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 899705
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153447
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153448
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153449
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153450
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0