CMS Formulary

Displaying 166071-166080 of 1611142 results.
ID: 166071
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166072
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 166073
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166074
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166075
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166076
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166077
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166078
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166079
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166080
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0