CMS Formulary

Displaying 158281-158290 of 1611142 results.
ID: 158281
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158282
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158283
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 877417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158284
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158285
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158286
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158287
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158288
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158289
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 158290
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0