CMS Formulary

Displaying 169451-169460 of 1611142 results.
ID: 169451
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169452
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169453
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169454
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169455
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169456
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169457
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169458
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169459
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 169460
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30