CMS Formulary

Displaying 174851-174860 of 1611142 results.
ID: 174851
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174852
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174853
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174854
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174855
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174856
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174857
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174858
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174859
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174860
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0