CMS Formulary

Displaying 169411-169420 of 1611142 results.
ID: 169411
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169412
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856660
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169413
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856652
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169414
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169415
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169416
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169417
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169418
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169419
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169420
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0