CMS Formulary

Displaying 175521-175530 of 1611142 results.
ID: 175521
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175522
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175523
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175524
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175525
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175526
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175527
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175528
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175529
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175530
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0