CMS Formulary

Displaying 156841-156850 of 1611142 results.
ID: 156841
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 156842
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156843
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 577154
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156844
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156845
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 403969
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156846
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 403972
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156847
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 403970
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156848
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 403971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156849
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 156850
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0