CMS Formulary

Displaying 159561-159570 of 1611142 results.
ID: 159561
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159562
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159563
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159564
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159565
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 159566
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 159567
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 159568
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159569
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 159570
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30