CMS Formulary

Displaying 168071-168080 of 1611142 results.
ID: 168071
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168072
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168073
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168074
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168075
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168076
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168077
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168078
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168079
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168080
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0