CMS Formulary

Displaying 168761-168770 of 1611142 results.
ID: 168761
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 168762
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168763
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310155
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168764
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 315090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168765
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310157
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168766
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168767
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 168768
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168769
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168770
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0