CMS Formulary

Displaying 164271-164280 of 1611142 results.
ID: 164271
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164272
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164273
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164274
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164275
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164276
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164277
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164278
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164279
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164280
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0