CMS Formulary

Displaying 168091-168100 of 1611142 results.
ID: 168091
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168092
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168093
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168094
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168095
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168096
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1049696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 168097
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168098
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168099
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168100
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0