CMS Formulary

Displaying 164361-164370 of 1611142 results.
ID: 164361
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164362
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164363
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164364
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164365
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164366
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164367
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164368
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164369
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164370
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30