CMS Formulary

Displaying 166271-166280 of 1611142 results.
ID: 166271
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166272
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166273
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166274
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166275
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166276
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166277
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166278
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166279
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1373503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166280
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30