CMS Formulary

Displaying 168951-168960 of 1611142 results.
ID: 168951
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 752388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168952
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 731281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168953
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652646
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168954
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168955
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168956
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168957
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 168958
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380236
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168959
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380260
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 168960
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311036
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0