CMS Formulary

Displaying 165181-165190 of 1611142 results.
ID: 165181
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165182
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165183
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165184
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165185
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 165186
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 165187
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 165188
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 165189
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165190
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0