CMS Formulary

Displaying 164891-164900 of 1611142 results.
ID: 164891
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164892
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164893
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164894
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164895
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164896
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 164897
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 164898
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164899
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164900
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30