CMS Formulary

Displaying 164181-164190 of 1611142 results.
ID: 164181
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164182
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164183
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164184
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164185
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164186
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164187
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 164188
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164189
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164190
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0