CMS Formulary

Displaying 163671-163680 of 1611142 results.
ID: 163671
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 163672
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163673
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163674
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163675
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163676
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163677
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 597967
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163678
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 597980
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163679
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 597974
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 163680
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 597987
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30