CMS Formulary

Displaying 158941-158950 of 1611142 results.
ID: 158941
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158942
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 158943
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 158944
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918209
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 158945
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918194
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 158946
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 158947
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 158948
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 158949
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1314763
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 158950
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0