CMS Formulary

Displaying 174811-174820 of 1611142 results.
ID: 174811
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174812
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205923
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174813
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174814
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 727545
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174815
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174816
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205912
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174817
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1605455
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174818
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 212218
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174819
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1649946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174820
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0