CMS Formulary

Displaying 169671-169680 of 1611142 results.
ID: 169671
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 618557
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169672
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311984
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169673
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311985
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169674
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 360344
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169675
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169676
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 606726
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 169677
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 606730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169678
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169679
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169680
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0