CMS Formulary

Displaying 163741-163750 of 1611142 results.
ID: 163741
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163742
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163743
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163744
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163745
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 163746
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163747
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163748
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 388517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163749
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163750
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0