CMS Formulary

Displaying 167641-167650 of 1611142 results.
ID: 167641
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 799054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167642
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167643
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167644
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 167645
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 900156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167646
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 848582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167647
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 824959
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167648
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167649
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167650
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0