CMS Formulary

Displaying 154281-154290 of 1611142 results.
ID: 154281
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154282
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154283
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154284
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154285
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154286
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 154287
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373493
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 154288
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373498
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 365
ID: 154289
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 154290
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28