CMS Formulary

Displaying 172421-172430 of 1611142 results.
ID: 172421
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 847189
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172422
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 847199
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172423
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172424
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172425
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172426
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172427
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172428
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172429
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172430
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0