CMS Formulary

Displaying 154101-154110 of 1611142 results.
ID: 154101
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 154102
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 154103
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 154104
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 154105
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154106
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154107
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154108
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154109
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154110
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0