CMS Formulary

Displaying 168641-168650 of 1611142 results.
ID: 168641
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 28
ID: 168642
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168643
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168644
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168645
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168646
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168647
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168648
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168649
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168650
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0