CMS Formulary

Displaying 169401-169410 of 1611142 results.
ID: 169401
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169402
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169403
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169404
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169405
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169406
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169407
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169408
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169409
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169410
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0