CMS Formulary

Displaying 169961-169970 of 1611142 results.
ID: 169961
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169962
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169963
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169964
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169965
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169966
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169967
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169968
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169969
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 169970
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 90