CMS Formulary

Displaying 167271-167280 of 1611142 results.
ID: 167271
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167272
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167273
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167274
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167275
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167276
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167277
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167278
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167279
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167280
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0