CMS Formulary

Displaying 167151-167160 of 1611142 results.
ID: 167151
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167152
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167153
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 167154
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167155
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167156
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167157
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167158
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167159
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167160
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0