CMS Formulary

Displaying 164791-164800 of 1611142 results.
ID: 164791
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 164792
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 164793
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 164794
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164795
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164796
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164797
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164798
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164799
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164800
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0