CMS Formulary

Displaying 166961-166970 of 1611142 results.
ID: 166961
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166962
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166963
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166964
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166965
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166966
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166967
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 166968
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166969
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166970
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0