CMS Formulary

Displaying 161241-161250 of 1611142 results.
ID: 161241
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 861379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161242
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 861383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161243
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1743549
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161244
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161245
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161246
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 161247
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 161248
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 161249
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 161250
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30