CMS Formulary

Displaying 153541-153550 of 1611142 results.
ID: 153541
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153542
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153543
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153544
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153545
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153546
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106648
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 130
Qty Limit Days: 31
ID: 153547
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153548
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153549
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153550
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0