CMS Formulary

Displaying 174961-174970 of 1611142 results.
ID: 174961
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 854848
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174962
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 854844
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174963
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1871465
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174964
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1871463
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174965
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1871461
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174966
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1871459
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174967
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1871469
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174968
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1871467
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 174969
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174970
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0