CMS Formulary

Displaying 166941-166950 of 1611142 results.
ID: 166941
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166942
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166943
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166944
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166945
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166946
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166947
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166948
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166949
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166950
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0