CMS Formulary

Displaying 167961-167970 of 1611142 results.
ID: 167961
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167962
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966184
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167963
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966190
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167964
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167965
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167966
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966204
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167967
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966211
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167968
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 476872
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167969
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966228
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 167970
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 966244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0