CMS Formulary

Displaying 168851-168860 of 1611142 results.
ID: 168851
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 168852
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168853
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168854
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 168855
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 168856
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 168857
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168858
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168859
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168860
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2104341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0