CMS Formulary

Displaying 158641-158650 of 1611142 results.
ID: 158641
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158642
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158643
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158644
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 352228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158645
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 158646
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 991722
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158647
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158648
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158649
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158650
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0