CMS Formulary

Displaying 169141-169150 of 1611142 results.
ID: 169141
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169142
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169143
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169144
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169145
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 169146
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169147
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169148
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169149
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 169150
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30