CMS Formulary

Displaying 168611-168620 of 1611142 results.
ID: 168611
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198116
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168612
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168613
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168614
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168615
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168616
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168617
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168618
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168619
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168620
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 284201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28