CMS Formulary

Displaying 157481-157490 of 1611142 results.
ID: 157481
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 157482
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 485486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157483
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 485485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157484
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 485484
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157485
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157486
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 157487
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 157488
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 157489
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157490
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0