CMS Formulary

Displaying 166461-166470 of 1611142 results.
ID: 166461
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166462
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166463
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 166464
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 166465
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 166466
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166467
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166468
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166469
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166470
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0