CMS Formulary

Displaying 153731-153740 of 1611142 results.
ID: 153731
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153732
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153733
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153734
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153735
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153736
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153737
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153738
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153739
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 153740
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31