CMS Formulary

Displaying 171311-171320 of 1611142 results.
ID: 171311
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171312
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 171313
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171314
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171315
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171316
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171317
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171318
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307427
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 30
ID: 171319
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171320
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861416
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0