CMS Formulary

Displaying 166651-166660 of 1611142 results.
ID: 166651
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858262
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166652
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166653
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166654
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166655
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166656
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166657
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166658
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166659
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1314768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 166660
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0