CMS Formulary

Displaying 158031-158040 of 1611142 results.
ID: 158031
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158032
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 158033
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1996246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158034
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 859081
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 158035
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 846192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158036
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 759697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158037
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 759481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158038
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 158039
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158040
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1111020
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0