CMS Formulary

Displaying 156171-156180 of 1611142 results.
ID: 156171
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156172
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 892494
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 156173
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 892596
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 156174
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 892345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 156175
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 894801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 156176
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 892352
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 156177
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 894814
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 156178
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 892554
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 156179
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156180
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0