CMS Formulary

Displaying 166021-166030 of 1611142 results.
ID: 166021
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166022
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166023
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166024
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166025
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166026
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166027
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166028
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166029
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166030
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30