CMS Formulary

Displaying 167001-167010 of 1611142 results.
ID: 167001
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167002
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 167003
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167004
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167005
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167006
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167007
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167008
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167009
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167010
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0