CMS Formulary

Displaying 171241-171250 of 1611142 results.
ID: 171241
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 171242
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 171243
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 171244
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 171245
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 171246
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171247
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171248
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171249
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171250
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30