CMS Formulary

Displaying 158291-158300 of 1611142 results.
ID: 158291
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 158292
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158293
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158294
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158295
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158296
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158297
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 180
ID: 158298
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158299
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 158300
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0