CMS Formulary

Displaying 170191-170200 of 1611142 results.
ID: 170191
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170192
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170193
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170194
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 902741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170195
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 902729
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170196
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 902736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170197
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306898
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170198
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170199
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170200
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30