CMS Formulary

Displaying 157021-157030 of 1611142 results.
ID: 157021
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 157022
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157023
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 157024
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157025
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157026
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157027
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 157028
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 157029
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 157030
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0