CMS Formulary

Displaying 169681-169690 of 1611142 results.
ID: 169681
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169682
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 618552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169683
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169684
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169685
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169686
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 169687
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 169688
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 169689
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169690
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 834235
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0