CMS Formulary

Displaying 166171-166180 of 1611142 results.
ID: 166171
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166172
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166173
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166174
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166175
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166176
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166177
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166178
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166179
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 30
ID: 166180
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30