CMS Formulary

Displaying 167191-167200 of 1611142 results.
ID: 167191
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167192
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167193
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167194
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167195
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167196
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167197
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 167198
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167199
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167200
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0