CMS Formulary

Displaying 173691-173700 of 1611142 results.
ID: 173691
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173692
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173693
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1812421
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173694
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1812425
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173695
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1812419
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173696
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1812427
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173697
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1494769
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173698
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173699
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 173700
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0