CMS Formulary

Displaying 158891-158900 of 1611142 results.
ID: 158891
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158892
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158893
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158894
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158895
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158896
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 158897
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158898
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158899
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158900
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0