CMS Formulary

Displaying 166701-166710 of 1611142 results.
ID: 166701
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166702
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166703
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166704
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166705
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166706
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166707
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166708
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166709
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166710
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30