CMS Formulary

Displaying 175051-175060 of 1611142 results.
ID: 175051
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175052
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175053
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175054
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175055
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175056
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175057
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 309332
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175058
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 197519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175059
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175060
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0