CMS Formulary

Displaying 171501-171510 of 1611142 results.
ID: 171501
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 171502
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171503
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171504
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171505
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171506
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171507
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171508
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171509
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171510
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0