CMS Formulary

Displaying 170161-170170 of 1611142 results.
ID: 170161
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170162
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170163
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170164
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170165
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170166
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170167
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170168
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170169
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170170
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0