CMS Formulary

Displaying 175691-175700 of 1611142 results.
ID: 175691
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1996246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175692
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 859081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175693
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175694
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175695
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175696
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175697
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2052826
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 175698
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 175699
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175700
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 2046370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1