CMS Formulary

Displaying 168351-168360 of 1611142 results.
ID: 168351
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168352
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168353
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168354
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168355
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168356
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168357
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168358
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168359
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168360
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0