CMS Formulary

Displaying 165731-165740 of 1611142 results.
ID: 165731
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165732
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2166143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 165733
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2196900
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 165734
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 180
ID: 165735
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1541594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165736
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165737
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165738
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165739
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165740
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0