CMS Formulary

Displaying 153821-153830 of 1611142 results.
ID: 153821
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153822
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153823
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 153824
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 153825
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153826
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153827
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153828
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153829
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153830
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0