CMS Formulary

Displaying 169191-169200 of 1611142 results.
ID: 169191
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169192
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169193
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169194
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169195
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169196
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169197
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169198
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169199
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169200
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28