CMS Formulary

Displaying 167951-167960 of 1611142 results.
ID: 167951
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167952
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167953
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167954
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167955
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167956
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167957
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966157
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167958
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167959
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167960
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966175
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0