CMS Formulary

Displaying 154001-154010 of 1611142 results.
ID: 154001
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154002
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154003
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154004
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154005
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154006
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154007
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154008
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154009
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 966157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154010
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 966164
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0