CMS Formulary

Displaying 173661-173670 of 1611142 results.
ID: 173661
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173662
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173663
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173664
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173665
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173666
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173667
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173668
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173669
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173670
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0