CMS Formulary

Displaying 172251-172260 of 1611142 results.
ID: 172251
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172252
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107518
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172253
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172254
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 172255
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 172256
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 172257
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 172258
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172259
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172260
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0