CMS Formulary

Displaying 158691-158700 of 1611142 results.
ID: 158691
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 158692
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 205301
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158693
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 315187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158694
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 856724
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158695
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 856733
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158696
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 309371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158697
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197577
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158698
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 343033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158699
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197579
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158700
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197580
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0