CMS Formulary

Displaying 172351-172360 of 1611142 results.
ID: 172351
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 172352
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 172353
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 172354
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172355
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172356
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172357
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 172358
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 172359
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 172360
Formulary ID: 00021071
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467575
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0