CMS Formulary

Displaying 159811-159820 of 1611142 results.
ID: 159811
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159812
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159813
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159814
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159815
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 159816
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159817
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159818
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 159819
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159820
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0