CMS Formulary

Displaying 173541-173550 of 1611142 results.
ID: 173541
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173542
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173543
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173544
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173545
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173546
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173547
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173548
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173549
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173550
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0