CMS Formulary

Displaying 164851-164860 of 1611142 results.
ID: 164851
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164852
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164853
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 164854
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164855
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164856
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 164857
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 164858
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 164859
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164860
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30