CMS Formulary

Displaying 170081-170090 of 1611142 results.
ID: 170081
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170082
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170083
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170084
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170085
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170086
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170087
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170088
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170089
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170090
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0