CMS Formulary

Displaying 167631-167640 of 1611142 results.
ID: 167631
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167632
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167633
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167634
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 167635
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167636
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167637
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167638
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167639
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 799055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167640
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 799056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0