CMS Formulary

Displaying 156271-156280 of 1611142 results.
ID: 156271
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156272
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156273
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156274
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156275
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156276
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156277
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156278
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156279
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156280
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30