CMS Formulary

Displaying 167391-167400 of 1611142 results.
ID: 167391
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167392
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167393
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167394
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545166
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167395
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545163
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167396
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545159
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167397
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1545156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167398
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167399
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167400
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0