CMS Formulary

Displaying 169031-169040 of 1611142 results.
ID: 169031
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169032
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169033
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169034
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169035
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169036
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169037
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169038
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169039
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169040
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0