CMS Formulary

Displaying 168841-168850 of 1611142 results.
ID: 168841
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168842
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168843
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168844
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045959
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168845
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045961
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168846
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2045958
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168847
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2059189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168848
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 168849
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 168850
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28