CMS Formulary

Displaying 153691-153700 of 1611142 results.
ID: 153691
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2286285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153692
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2396905
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 153693
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 352044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153694
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 352045
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153695
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 352046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153696
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 352047
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153697
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654955
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153698
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 731227
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153699
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 731250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153700
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 730046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0