CMS Formulary

Displaying 168511-168520 of 1611142 results.
ID: 168511
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168512
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168513
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168514
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168515
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168516
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168517
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168518
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168519
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168520
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30