CMS Formulary

Displaying 169301-169310 of 1611142 results.
ID: 169301
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169302
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169303
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169304
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309043
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169305
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169306
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169307
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169308
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169309
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169310
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0