CMS Formulary

Displaying 170861-170870 of 1611142 results.
ID: 170861
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170862
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170863
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170864
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170865
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170866
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170867
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811011
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170868
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811007
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170869
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811003
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 170870
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1810999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30