CMS Formulary

Displaying 160971-160980 of 1611142 results.
ID: 160971
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160972
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160973
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160974
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 160975
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 160976
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160977
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160978
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160979
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160980
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0