CMS Formulary

Displaying 165411-165420 of 1611142 results.
ID: 165411
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 165412
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 165413
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178407
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 28
ID: 165414
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 165415
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 165416
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 165417
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272630
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 165418
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 165419
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 165420
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30