CMS Formulary

Displaying 163641-163650 of 1611142 results.
ID: 163641
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163642
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 311989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163643
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163644
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 163645
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163646
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163647
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163648
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163649
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163650
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0