CMS Formulary

Displaying 160871-160880 of 1611142 results.
ID: 160871
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 160872
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 160873
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 160874
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 160875
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 160876
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 160877
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 160878
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 160879
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 160880
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370982
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30