CMS Formulary

Displaying 164471-164480 of 1611142 results.
ID: 164471
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164472
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164473
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164474
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164475
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164476
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164477
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164478
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164479
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164480
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0