CMS Formulary

Displaying 156681-156690 of 1611142 results.
ID: 156681
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 156682
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 156683
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 156684
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 156685
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156686
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 156687
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156688
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156689
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156690
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0