CMS Formulary

Displaying 167201-167210 of 1611142 results.
ID: 167201
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 167202
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167203
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 167204
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 167205
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167206
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167207
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167208
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 167209
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167210
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0