CMS Formulary

Displaying 165361-165370 of 1611142 results.
ID: 165361
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369737
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165362
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165363
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165364
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165365
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165366
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165367
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165368
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 165369
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165370
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0