CMS Formulary

Displaying 158351-158360 of 1611142 results.
ID: 158351
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158352
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2107518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158353
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158354
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 158355
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 158356
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 158357
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 158358
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158359
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158360
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0