CMS Formulary

Displaying 164981-164990 of 1611142 results.
ID: 164981
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164982
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164983
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164984
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164985
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164986
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164987
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 540617
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164988
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164989
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 213337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 164990
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0