CMS Formulary

Displaying 164881-164890 of 1611142 results.
ID: 164881
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164882
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164883
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164884
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164885
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164886
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164887
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164888
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164889
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 861783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 164890
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0