CMS Formulary

Displaying 160781-160790 of 1611142 results.
ID: 160781
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160782
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160783
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160784
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160785
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160786
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160787
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160788
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160789
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 160790
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0