CMS Formulary

Displaying 169091-169100 of 1611142 results.
ID: 169091
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 169092
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169093
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 169094
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169095
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169096
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 756059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169097
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 169098
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 169099
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 169100
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 205301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0