CMS Formulary

Displaying 161871-161880 of 1611142 results.
ID: 161871
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161872
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161873
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 161874
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161875
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161876
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161877
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161878
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161879
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 161880
Formulary ID: 00021064
Formulary Version: 15
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0