CMS Formulary

Displaying 170761-170770 of 1611142 results.
ID: 170761
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170762
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170763
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170764
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170765
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170766
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170767
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170768
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170769
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170770
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0