CMS Formulary

Displaying 100171-100180 of 1611142 results.
ID: 100171
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 476872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100172
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 100173
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 100174
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 100175
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100176
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100177
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100178
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100179
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 100180
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0