CMS Formulary

Displaying 158361-158370 of 1611142 results.
ID: 158361
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158362
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158363
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158364
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158365
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 158366
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 158367
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 158368
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1365979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158369
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158370
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0