CMS Formulary

Displaying 167721-167730 of 1611142 results.
ID: 167721
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167722
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167723
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167724
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167725
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167726
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 167727
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 28
ID: 167728
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 167729
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1100075
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 167730
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30