CMS Formulary

Displaying 167851-167860 of 1611142 results.
ID: 167851
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167852
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167853
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167854
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 167855
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167856
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167857
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 167858
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167859
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167860
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0