CMS Formulary

Displaying 171841-171850 of 1611142 results.
ID: 171841
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 171842
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171843
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171844
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171845
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171846
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171847
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 171848
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 171849
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171850
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0