CMS Formulary

Displaying 165701-165710 of 1611142 results.
ID: 165701
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 165702
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 165703
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165704
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165705
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165706
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165707
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165708
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165709
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165710
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30