CMS Formulary

Displaying 168701-168710 of 1611142 results.
ID: 168701
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168702
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 168703
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168704
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168705
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168706
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168707
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168708
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 830877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168709
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 830879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168710
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 830882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0