CMS Formulary

Displaying 161-170 of 1611142 results.
ID: 161
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 162
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 163
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 700
Qty Limit Days: 30
ID: 165
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 166
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 167
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 168
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0