CMS Formulary

Displaying 173641-173650 of 1611142 results.
ID: 173641
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1657173
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 173642
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 173643
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173644
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173645
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173646
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173647
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173648
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173649
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173650
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0