CMS Formulary

Displaying 159701-159710 of 1611142 results.
ID: 159701
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159702
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159703
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159704
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 159705
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159706
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159707
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159708
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159709
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159710
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0