CMS Formulary

Displaying 165931-165940 of 1611142 results.
ID: 165931
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 165932
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 165933
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 165934
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165935
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165936
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165937
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165938
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 359493
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 165939
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 359494
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 165940
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0