CMS Formulary

Displaying 166391-166400 of 1611142 results.
ID: 166391
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166392
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166393
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28
ID: 166394
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166395
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166396
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166397
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166398
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166399
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166400
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0