CMS Formulary

Displaying 163991-164000 of 1611142 results.
ID: 163991
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163992
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163993
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163994
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 163995
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 163996
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 163997
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 163998
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 163999
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 164000
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30