CMS Formulary

Displaying 165091-165100 of 1611142 results.
ID: 165091
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165092
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165093
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165094
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165095
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165096
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165097
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1874537
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165098
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165099
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165100
Formulary ID: 00021065
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0