CMS Formulary

Displaying 169291-169300 of 1611142 results.
ID: 169291
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169292
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169293
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169294
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169295
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169296
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 44
Qty Limit Days: 30
ID: 169297
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169298
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169299
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169300
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0