CMS Formulary

Displaying 159111-159120 of 1611142 results.
ID: 159111
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 159112
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 159113
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 159114
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159115
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159116
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159117
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159118
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159119
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159120
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0