CMS Formulary

Displaying 166111-166120 of 1611142 results.
ID: 166111
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166112
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166113
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166114
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166115
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166116
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166117
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 847917
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 166118
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 847913
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 166119
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1990869
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 166120
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0