CMS Formulary

Displaying 167411-167420 of 1611142 results.
ID: 167411
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167412
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1811011
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167413
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1811007
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167414
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1811003
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167415
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1810999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167416
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167417
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167418
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 167419
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167420
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0