CMS Formulary

Displaying 167011-167020 of 1611142 results.
ID: 167011
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167012
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167013
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167014
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167015
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 167016
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167017
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167018
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 984105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167019
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167020
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0