CMS Formulary

Displaying 172961-172970 of 1611142 results.
ID: 172961
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172962
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172963
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172964
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172965
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172966
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172967
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172968
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172969
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172970
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0