CMS Formulary

Displaying 158411-158420 of 1611142 results.
ID: 158411
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 158412
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 158413
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 158414
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158415
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2104341
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158416
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158417
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158418
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158419
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158420
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0