CMS Formulary

Displaying 168871-168880 of 1611142 results.
ID: 168871
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 168872
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 168873
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 168874
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168875
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168876
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168877
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178407
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168878
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168879
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168880
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0