CMS Formulary

Displaying 166371-166380 of 1611142 results.
ID: 166371
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166372
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 166373
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166374
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166375
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166376
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166377
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166378
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166379
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166380
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0