CMS Formulary

Displaying 167831-167840 of 1611142 results.
ID: 167831
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167832
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 167833
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 167834
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167835
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167836
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167837
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167838
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167839
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167840
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30