CMS Formulary

Displaying 170921-170930 of 1611142 results.
ID: 170921
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 170922
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170923
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 170924
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170925
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170926
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 170927
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 170928
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 170929
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 170930
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0