CMS Formulary

Displaying 166131-166140 of 1611142 results.
ID: 166131
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310473
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166132
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 242816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166133
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1870633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166134
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166135
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166136
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166137
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1863973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166138
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166139
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1863605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166140
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 615099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0