CMS Formulary

Displaying 168241-168250 of 1611142 results.
ID: 168241
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168242
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168243
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168244
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 168245
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 168246
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399898
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 168247
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 168248
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168249
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168250
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0