CMS Formulary

Displaying 172151-172160 of 1611142 results.
ID: 172151
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172152
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 172153
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172154
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172155
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172156
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172157
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 172158
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172159
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172160
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0