CMS Formulary

Displaying 174861-174870 of 1611142 results.
ID: 174861
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 860510
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174862
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 860516
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174863
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 860522
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174864
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 860532
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174865
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174866
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174867
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174868
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174869
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174870
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0