CMS Formulary

Displaying 170411-170420 of 1611142 results.
ID: 170411
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170412
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170413
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170414
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170415
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170416
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170417
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170418
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170419
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170420
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30