CMS Formulary

Displaying 173141-173150 of 1611142 results.
ID: 173141
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 858044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173142
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 858040
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173143
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1043567
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173144
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1043582
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173145
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1043574
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173146
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173147
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173148
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173149
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173150
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0