CMS Formulary

Displaying 170611-170620 of 1611142 results.
ID: 170611
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170612
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170613
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797895
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 170614
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170615
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170616
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170617
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 28
ID: 170618
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170619
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235049
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170620
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 705129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0