CMS Formulary

Displaying 166191-166200 of 1611142 results.
ID: 166191
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 166192
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 166193
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 166194
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166195
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166196
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166197
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 876529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166198
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166199
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166200
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0