CMS Formulary

Displaying 168921-168930 of 1611142 results.
ID: 168921
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 311286
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168922
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 242754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168923
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168924
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168925
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168926
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168927
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168928
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168929
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168930
Formulary ID: 00021067
Formulary Version: 13
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0