CMS Formulary

Displaying 166721-166730 of 1611142 results.
ID: 166721
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166722
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166723
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166724
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166725
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166726
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166727
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 730866
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166728
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 730861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166729
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 730872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166730
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0