CMS Formulary

Displaying 167491-167500 of 1611142 results.
ID: 167491
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167492
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167493
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167494
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167495
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167496
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167497
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167498
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167499
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167500
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0