CMS Formulary

Displaying 168081-168090 of 1611142 results.
ID: 168081
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168082
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168083
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168084
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168085
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168086
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168087
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168088
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168089
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168090
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0