CMS Formulary

Displaying 169061-169070 of 1611142 results.
ID: 169061
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169062
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169063
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169064
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 169065
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 169066
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169067
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169068
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 169069
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 169070
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0