CMS Formulary

Displaying 170561-170570 of 1611142 results.
ID: 170561
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 597987
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170562
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 597977
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170563
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 597971
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170564
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170565
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170566
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170567
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170568
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170569
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170570
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0