CMS Formulary

Displaying 155461-155470 of 1611142 results.
ID: 155461
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155462
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155463
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155464
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155465
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 155466
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155467
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155468
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155469
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155470
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30