CMS Formulary

Displaying 158271-158280 of 1611142 results.
ID: 158271
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158272
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158273
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158274
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 158275
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158276
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158277
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158278
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158279
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158280
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30