CMS Formulary

Displaying 158131-158140 of 1611142 results.
ID: 158131
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 158132
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158133
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158134
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158135
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158136
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 158137
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158138
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158139
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158140
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0