CMS Formulary

Displaying 171481-171490 of 1611142 results.
ID: 171481
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171482
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171483
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 404587
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171484
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171485
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 639888
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171486
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744003
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171487
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744007
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171488
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744011
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171489
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 171490
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0