CMS Formulary

Displaying 161691-161700 of 1611142 results.
ID: 161691
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 161692
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 161693
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 161694
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161695
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161696
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161697
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161698
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161699
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161700
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0