CMS Formulary

Displaying 171231-171240 of 1611142 results.
ID: 171231
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171232
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 104206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171233
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1998774
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 171234
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1998772
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 30
ID: 171235
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171236
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171237
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171238
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171239
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171240
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28