CMS Formulary

Displaying 157351-157360 of 1611142 results.
ID: 157351
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 157352
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 157353
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157354
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157355
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 157356
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 157357
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157358
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 809477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157359
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157360
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0