CMS Formulary

Displaying 166751-166760 of 1611142 results.
ID: 166751
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 212438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166752
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 212437
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166753
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166754
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166755
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166756
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166757
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166758
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166759
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166760
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0