CMS Formulary

Displaying 175981-175990 of 1611142 results.
ID: 175981
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 692576
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175982
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 692578
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175983
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175984
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175985
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175986
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175987
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175988
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175989
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 175990
Formulary ID: 00021075
Formulary Version: 23
Contract Year: 2021
RXCUI: 198007
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0