CMS Formulary

Displaying 170101-170110 of 1611142 results.
ID: 170101
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 22
Qty Limit Days: 28
ID: 170102
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 170103
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 22
Qty Limit Days: 28
ID: 170104
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 170105
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 406503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170106
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 858262
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170107
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 310023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170108
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170109
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170110
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0