CMS Formulary

Displaying 154171-154180 of 1611142 results.
ID: 154171
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154172
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154173
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154174
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154175
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154176
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154177
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2360548
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154178
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154179
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154180
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0