CMS Formulary

Displaying 169661-169670 of 1611142 results.
ID: 169661
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 966224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169662
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 966225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169663
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169664
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169665
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169666
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169667
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 790489
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169668
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 763519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169669
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 763574
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169670
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 763589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0