CMS Formulary

Displaying 170301-170310 of 1611142 results.
ID: 170301
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170302
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 170303
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 170304
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 170305
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 170306
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170307
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170308
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170309
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170310
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0