CMS Formulary

Displaying 170141-170150 of 1611142 results.
ID: 170141
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170142
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170143
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012017
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170144
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170145
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170146
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170147
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 170148
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170149
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170150
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0