CMS Formulary

Displaying 166361-166370 of 1611142 results.
ID: 166361
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1608333
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166362
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166363
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166364
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166365
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166366
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166367
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166368
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166369
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166370
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28