CMS Formulary

Displaying 170401-170410 of 1611142 results.
ID: 170401
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170402
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170403
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170404
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170405
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170406
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170407
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170408
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 170409
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170410
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0