CMS Formulary

Displaying 174201-174210 of 1611142 results.
ID: 174201
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174202
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174203
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174204
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174205
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174206
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174207
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174208
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1608276
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174209
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1608274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174210
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0