CMS Formulary

Displaying 166951-166960 of 1611142 results.
ID: 166951
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166952
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 166953
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 166954
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166955
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166956
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166957
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166958
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166959
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166960
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0