CMS Formulary

Displaying 168561-168570 of 1611142 results.
ID: 168561
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168562
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168563
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1874537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168564
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168565
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168566
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168567
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168568
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 168569
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168570
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30