CMS Formulary

Displaying 170361-170370 of 1611142 results.
ID: 170361
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170362
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170363
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170364
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170365
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1043025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170366
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1043031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170367
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170368
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170369
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170370
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 884522
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0