CMS Formulary

Displaying 171951-171960 of 1611142 results.
ID: 171951
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171952
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171953
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 10
ID: 171954
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 10
ID: 171955
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171956
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171957
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171958
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171959
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 171960
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0