CMS Formulary

Displaying 170681-170690 of 1611142 results.
ID: 170681
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170682
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 170683
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170684
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 170685
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170686
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170687
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170688
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170689
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170690
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0