CMS Formulary

Displaying 158481-158490 of 1611142 results.
ID: 158481
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158482
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158483
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158484
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158485
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158486
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158487
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158488
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158489
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158490
Formulary ID: 00021063
Formulary Version: 13
Contract Year: 2021
RXCUI: 1491634
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0