CMS Formulary

Displaying 174391-174400 of 1611142 results.
ID: 174391
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174392
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174393
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174394
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174395
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174396
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174397
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174398
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174399
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174400
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0