CMS Formulary

Displaying 156731-156740 of 1611142 results.
ID: 156731
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 388517
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156732
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 156733
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156734
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156735
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 156736
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 156737
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156738
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 156739
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156740
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0