CMS Formulary

Displaying 175791-175800 of 1611142 results.
ID: 175791
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175792
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175793
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175794
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 310154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175795
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175796
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175797
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175798
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175799
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175800
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0