CMS Formulary

Displaying 169251-169260 of 1611142 results.
ID: 169251
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169252
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169253
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169254
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169255
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169256
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 746804
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 169257
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 746815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 169258
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 746813
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 169259
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 790284
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 169260
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2196792
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30