CMS Formulary

Displaying 165851-165860 of 1611142 results.
ID: 165851
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165852
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165853
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165854
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165855
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165856
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165857
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165858
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165859
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165860
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0