CMS Formulary

Displaying 100161-100170 of 1611142 results.
ID: 100161
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100162
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100163
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100164
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100165
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100166
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100167
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100168
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100169
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100170
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0