CMS Formulary

Displaying 159451-159460 of 1611142 results.
ID: 159451
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159452
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159453
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159454
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159455
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159456
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159457
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159458
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159459
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159460
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0