CMS Formulary

Displaying 167651-167660 of 1611142 results.
ID: 167651
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167652
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167653
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167654
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167655
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1743547
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167656
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167657
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1665517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167658
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167659
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167660
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0