CMS Formulary

Displaying 166611-166620 of 1611142 results.
ID: 166611
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 166612
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 388525
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 30
ID: 166613
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 360507
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166614
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166615
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166616
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166617
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 892494
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 166618
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 892596
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 166619
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 892345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 166620
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 894801
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30