CMS Formulary

Displaying 158901-158910 of 1611142 results.
ID: 158901
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158902
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158903
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158904
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158905
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 110
Qty Limit Days: 30
ID: 158906
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158907
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158908
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158909
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158910
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0