CMS Formulary

Displaying 155811-155820 of 1611142 results.
ID: 155811
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155812
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155813
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155814
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155815
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 155816
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 155817
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 155818
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155819
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 155820
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1855389
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0