CMS Formulary

Displaying 168341-168350 of 1611142 results.
ID: 168341
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 849398
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168342
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 849431
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168343
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 168344
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168345
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168346
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168347
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168348
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168349
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168350
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0