CMS Formulary

Displaying 175361-175370 of 1611142 results.
ID: 175361
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175362
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175363
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175364
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175365
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175366
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175367
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 204509
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175368
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175369
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175370
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1722919
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0