CMS Formulary

Displaying 157071-157080 of 1611142 results.
ID: 157071
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157072
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157073
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157074
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 157075
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 157076
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157077
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157078
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157079
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157080
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0