CMS Formulary

Displaying 168361-168370 of 1611142 results.
ID: 168361
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168362
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168363
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168364
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168365
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168366
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168367
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168368
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168369
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168370
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0