CMS Formulary

Displaying 154111-154120 of 1611142 results.
ID: 154111
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154112
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154113
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154114
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154115
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154116
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154117
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154118
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154119
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154120
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0