CMS Formulary

Displaying 170701-170710 of 1611142 results.
ID: 170701
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170702
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 170703
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 170704
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001430
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170705
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170706
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2043464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170707
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246321
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170708
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170709
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170710
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0