CMS Formulary

Displaying 169051-169060 of 1611142 results.
ID: 169051
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169052
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169053
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169054
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 205739
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169055
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 352228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169056
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169057
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169058
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169059
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169060
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0