CMS Formulary

Displaying 157831-157840 of 1611142 results.
ID: 157831
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 157832
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 157833
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 157834
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 157835
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157836
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 157837
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 157838
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157839
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 157840
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0