CMS Formulary

Displaying 164021-164030 of 1611142 results.
ID: 164021
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164022
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164023
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164024
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164025
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164026
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164027
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164028
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164029
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164030
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0