CMS Formulary

Displaying 167971-167980 of 1611142 results.
ID: 167971
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167972
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966232
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167973
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966233
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167974
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966235
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167975
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966237
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167976
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167977
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167978
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167979
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966243
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167980
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30