CMS Formulary

Displaying 167181-167190 of 1611142 results.
ID: 167181
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 167182
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167183
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 167184
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167185
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167186
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 236
Qty Limit Days: 28
ID: 167187
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167188
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167189
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167190
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0