CMS Formulary

Displaying 173561-173570 of 1611142 results.
ID: 173561
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173562
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173563
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173564
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173565
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173566
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173567
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173568
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173569
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173570
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0