CMS Formulary

Displaying 172471-172480 of 1611142 results.
ID: 172471
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172472
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172473
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172474
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172475
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172476
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172477
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172478
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172479
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172480
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0