CMS Formulary

Displaying 174511-174520 of 1611142 results.
ID: 174511
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1810999
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174512
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174513
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174514
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 174515
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174516
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174517
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174518
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174519
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174520
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1