CMS Formulary

Displaying 166931-166940 of 1611142 results.
ID: 166931
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166932
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166933
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166934
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166935
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166936
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166937
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166938
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166939
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 166940
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0