CMS Formulary

Displaying 171251-171260 of 1611142 results.
ID: 171251
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 171252
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 171253
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171254
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171255
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 171256
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 171257
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171258
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 809477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171259
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171260
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0