CMS Formulary

Displaying 154951-154960 of 1611142 results.
ID: 154951
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2399661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154952
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054275
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 154953
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2104341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 56
ID: 154954
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2198966
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 154955
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197890
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 154956
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 62
Qty Limit Days: 31
ID: 154957
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 154958
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 154959
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31
ID: 154960
Formulary ID: 00021062
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 31
Qty Limit Days: 31