CMS Formulary

Displaying 159921-159930 of 1611142 results.
ID: 159921
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159922
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159923
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159924
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159925
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159926
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 159927
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 159928
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159929
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 159930
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0