CMS Formulary

Displaying 154681-154690 of 1611142 results.
ID: 154681
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 198116
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154682
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154683
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 154684
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 154685
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154686
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154687
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154688
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154689
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154690
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 284201
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28