CMS Formulary

Displaying 170741-170750 of 1611142 results.
ID: 170741
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170742
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170743
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 577154
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170744
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170745
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170746
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403972
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170747
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403970
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170748
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 403971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170749
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170750
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0