CMS Formulary

Displaying 156651-156660 of 1611142 results.
ID: 156651
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156652
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 156653
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156654
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156655
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156656
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156657
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156658
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 597967
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156659
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 597980
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 156660
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 597974
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30