CMS Formulary

Displaying 158341-158350 of 1611142 results.
ID: 158341
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 198037
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158342
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158343
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158344
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158345
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158346
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 158347
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 158348
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 158349
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158350
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1867544
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0