CMS Formulary

Displaying 175171-175180 of 1611142 results.
ID: 175171
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175172
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175173
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175174
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175175
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175176
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175177
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175178
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175179
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175180
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 308720
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0