CMS Formulary

Displaying 166881-166890 of 1611142 results.
ID: 166881
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166882
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166883
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166884
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166885
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 750839
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166886
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 686405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166887
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 206075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166888
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 206078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166889
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1293504
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166890
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 669081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0