CMS Formulary

Displaying 164411-164420 of 1611142 results.
ID: 164411
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164412
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164413
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164414
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 260376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164415
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 328161
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164416
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197971
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164417
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164418
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164419
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164420
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0