CMS Formulary

Displaying 166251-166260 of 1611142 results.
ID: 166251
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166252
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166253
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 208327
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166254
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166255
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166256
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166257
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166258
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166259
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166260
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30