CMS Formulary

Displaying 169861-169870 of 1611142 results.
ID: 169861
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169862
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169863
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169864
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169865
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169866
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169867
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169868
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169869
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 169870
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0