CMS Formulary

Displaying 169151-169160 of 1611142 results.
ID: 169151
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169152
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169153
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 169154
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 169155
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 169156
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169157
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169158
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169159
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169160
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0