CMS Formulary

Displaying 175631-175640 of 1611142 results.
ID: 175631
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 175632
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 175633
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175634
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 647237
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175635
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 647239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175636
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198313
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175637
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198312
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175638
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 643123
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175639
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 643125
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175640
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0