CMS Formulary

Displaying 166791-166800 of 1611142 results.
ID: 166791
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166792
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166793
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166794
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166795
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166796
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166797
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166798
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166799
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166800
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0