CMS Formulary

Displaying 168891-168900 of 1611142 results.
ID: 168891
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966187
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168892
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2104866
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168893
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168894
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966202
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168895
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966207
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168896
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 168897
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 168898
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 168899
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168900
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0