CMS Formulary

Displaying 168651-168660 of 1611142 results.
ID: 168651
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168652
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168653
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168654
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 168655
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168656
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168657
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 897781
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168658
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 897783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168659
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 897844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168660
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0