CMS Formulary

Displaying 158381-158390 of 1611142 results.
ID: 158381
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 197840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158382
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158383
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158384
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158385
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158386
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1673373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158387
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158388
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1011712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158389
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1011715
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158390
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1011752
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0