CMS Formulary

Displaying 169641-169650 of 1611142 results.
ID: 169641
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169642
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169643
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169644
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169645
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169646
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 169647
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 169648
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 169649
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169650
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0