CMS Formulary

Displaying 167701-167710 of 1611142 results.
ID: 167701
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 167702
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 167703
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 167704
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 167705
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 167706
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167707
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167708
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167709
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167710
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0