CMS Formulary

Displaying 162461-162470 of 1611142 results.
ID: 162461
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 162462
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 162463
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 162464
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 899511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 162465
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 899439
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 162466
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006608
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 162467
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 162468
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 162469
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 162470
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876397
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0