CMS Formulary

Displaying 165991-166000 of 1611142 results.
ID: 165991
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165992
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165993
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165994
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165995
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165996
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165997
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165998
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 165999
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166000
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0