CMS Formulary

Displaying 167941-167950 of 1611142 results.
ID: 167941
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167942
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167943
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167944
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167945
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167946
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 167947
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167948
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 607295
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167949
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167950
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0