CMS Formulary

Displaying 173671-173680 of 1611142 results.
ID: 173671
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173672
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173673
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173674
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173675
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173676
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173677
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173678
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173679
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173680
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 360507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0