CMS Formulary

Displaying 167591-167600 of 1611142 results.
ID: 167591
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167592
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167593
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167594
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 852920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167595
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167596
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167597
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167598
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167599
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 167600
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0