CMS Formulary

Displaying 167291-167300 of 1611142 results.
ID: 167291
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403972
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167292
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403970
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167293
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 403971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167294
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167295
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167296
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167297
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 721787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167298
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167299
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167300
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0