CMS Formulary

Displaying 153881-153890 of 1611142 results.
ID: 153881
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153882
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 124
Qty Limit Days: 31
ID: 153883
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153884
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153885
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153886
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153887
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153888
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 153889
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 153890
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31