CMS Formulary

Displaying 166581-166590 of 1611142 results.
ID: 166581
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166582
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166583
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166584
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166585
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 828755
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166586
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 828539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166587
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166588
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 645884
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166589
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166590
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0