CMS Formulary

Displaying 174971-174980 of 1611142 results.
ID: 174971
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174972
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174973
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174974
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174975
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174976
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174977
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174978
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174979
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 174980
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0